Research on the Promotion of Physical and Health Literacy in four Settings (Sport Clubs, Schools, Co

Moving for Health

Research on the Promotion of Physical and Health Literacy in four Settings (Sport Clubs, Schools, Communities and Health Centres)

Contents 1. Introduction | 4 2. Fundamentals of Health Literacy (HL) Physical Literacy (PL) | 6 2.1. Why does it matter? | 7 2.2. Theoretical constructs – Physical Literacy | 7 2.3. Theoretical constructs – Health Literacy | 7 2.4. Linking Physical and Health Literacies | 7 2.5. Real world examples | 8 2.6. Life span and environment (holistic conceptualisation) | 8 2.7. Different approaches (environmental, family, organisational, multi-sector) | 3. What8 really matters | 11 4. Sport clubs’ promotion | 13 4.1. Overall principles to design sport clubs’ programmes | 14 4.2.Health promotion in sports clubs | 14 4.3. Inclusive sports participation | 15 4.4. Holistic and collaborative approach | 16 4.5. Open questions | 17 4.6. Good practices | 18 Good Practice 1 | 19 Good Practice 2 | 20 Good Practice 3 | 21 5. School promotion | 22 5.1. Overall principles to design school programmes | 23 5.2. Whole-school approach | 23 5.3. Quality physical education | 24 5.4. Family and community engagement | 25 5.5. Open questions | 26 5.6. Good practices | 26 Good Practice 4 | 27 Good Practice 5 | 28 Good Practice 6 | 29 Good Practice 7 | 30 Good Practice 8 | 31 Good Practice 9 | 32 Good Practice 10 | 33 Good Practice 11 | 34 6. Community promotion | 35 6.1. Overall principles to design community programmes | 36 6.2. Active Transportation | 37

6.3. Inclusive Design | 37 6.4. Autonomy | 38 6.5. Intergenerational Connections | 38 6.6. Community Engagement | 39 6.7. Cross sectoral Collaboration | 39 6.8. Digital Innovation in Health and Physical Literacy | 39 6.9. Sustainability in Health and Physical Literacy Initiatives | 40 6.10. Assessment of Health and Physical Literacy Initiatives | 40 6.11. Conclusion | 41 6.12. Open Questions | 41 6.13. Good practices | 41 Good Practice 12 | 42 Good Practice 13 | 43 Good Practice 14 | 44 Good Practice 15 | 45 Good Practice 16 | 46 Good Practice 17 | 47 Good Practice 18 | 48 Good Practice 19 | 49 7. Health Centres Promotion | 50 7.1. Introduction | 51 7.2. Overall Principles for Health Centres Design | 51 7.3. Personal Capacity Building | 52 7.4. Health Literacy | 52 7.5. Digital Health Literacy | 53 7.6. Lifelong Learning on the Relationship between PL and HL | 53 7.7. From an Individual to a Collective Action | 54 7.8. Social Cohesion | 54 7.9. Physical Literacy | 54 7.10. Evaluation and Assessment | 55 7.11. Open Questions | 56 7.12. Conclusion | 56 7.13. Good practices | 56 Good Practice 20 | 57 Good Practice 21 | 58 Good Practice 22 | 59 Good Practice 23 | 60 Good Practice 24 | 61 Good Practice 25 | 62 8. References | 63

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Introduction

Physical and health literacy are two foundational concepts in promoting a healthy lifestyle, emphasising the skills, knowledge and attitude necessary to lead an active and healthy life. In the context of the Moving for Health (MfH) project, these literacies are explored as part of a comprehensive model that supports sustainable health and well-being. The following pages outline how physical and health literacy can empower individuals by providing them with the necessary capabilities to make informed health decisions, understand the benefits of physical activity and transport this knowledge into various settings, namely sport clubs, schools, communities and health centres.

By focusing on these four key settings, the MfH model offers a holistic approach to help cultivating healthy habits across different stages of life and socio-economic statuses. Through targeted strategies in each setting, the project aims to create supportive environments where individuals can build the competences needed to sustain a healthy lifestyle, improving both personal and public health outcomes.

SCHOOL PROMOTION Overall principles to design sport clubs’ programmes Topics to cover • Whole-school approach • Quality physical education • Family and community engagement • Open Questions and Good Practices

COMMUNITY PROMOTION Overall principles to design community programmes

Fundamentals of Health Literacy and Physical Literacy Why does it matter • Theoretical constructs, components (value for life) • Linking HL and PL • Real-world examples

SPORT ORGANISATIONS PROMOTION Overall principles to design sport organisations’ programmes Topics to cover • Health promotion in sports clubs • Inclusive sports participation • Holistic and collaborative approach • (internal and external) • Open Questions and Good Practices

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• Life span and environment (holistic conceptualisation) • Different approaches (environmental, family, organisational, multi-sectoral) • What really matters Professionals are the drivers of change Tailored approaches Empowerment and awareness Shared decision-making

Topics to cover • Active transportation • Physical environmental design • Autonomy • Intergenerational connections • Community Engagement • Cross sectoral collaboration • Innovation • Sustainability

HEALTH CENTRES PROMOTION Overall principles for Health Centers design Topics to cover • Personal capacity building (health/PL promotion/) • Health literacy • Digital Health literacy • Lifelong learning on relationship between PL/HL • From individual to collective • Social Cohesion • Physical Literacy • Evaluation and Assessment • Open Question and Good Practices

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Fundamentals of Health Literacy (HL) and Physical Literacy (PL)

2.1.

Why does it matter?

Over the past decade, physical literacy (PL) has been used to describe an individual’s development level in relation to engaging in physical activity and its promotion within society. Research shows that higher levels of physical literacy enhance an individual’s ability to lead an active, healthy lifestyle and engage in physical activity and sport. PL has been closely linked to various aspects of well-being and quality of life, including key health indicators.

Recently, PL has also been associated with health literacy (HL), which encompasses an individual’s knowledge, the perception and behaviour regarding health and illness. Low levels of HL can reduce the ability to promote health and prevent illness, increasing the risk of physical and mental health issues.

Evidence suggests that the general population has rather low levels of PL and HL, underscoring the need for targeted initiatives to raise awareness and improve PL and HL through education and training across various domain of social life: sport clubs, schools, community and health.

2.2.

Theoretical constructs – Physical Literacy PL has had various definitions proposed by different groups of scholars.

In a recent Erasmus Sport Project that sought to integrate these different contributions, PL was defined as ‘[…] the skills and attributes that individuals demonstrate through physical activity and movement throughout their life course. It can be understood as both a process and an outcome that individuals pursue through the interaction of their physical, emotional, social and cognitive learning’1. These four types of learning are the interrelated pillars that support the holistic development of PL to help all generations lead an active, healthy and fulfilling lifestyle.

2.3.

Theoretical constructs – Health Literacy Health literacy (HL) can be defined as a dynamic concept that refers to an individual’s knowledge, the perception and behaviour, based on a complex set of interactions relating to their health and illness. Health literacy depends on socio-economic and cultural conditions, as well as different skills (writing, reading, listening and speaking). Four dimensions of HL competences are usually referred to: 1) access to obtain health-relevant information; 2) understanding health-relevant information; 3) processing/evaluating healthrelevant information; and 4) applying/utilizing health-relevant information. These competences should enable people to act in three health domains: 1) health care; 2) disease prevention; and 3) health promotion.

2.4.

Linking Physical and Health Literacies Although some authors believe that PL should not be understood as a solely health-driven concept, research into PL clearly recognises its effect on people’s health. People with proficient physical literacy tend to resolve existing health problems through physical activity, also preventing the onset of various diseases. Health can even be conceived as a complete state based on physical, mental and social adaptability and morality coupled to physical literacy through the engagement in qualitative physical activity. Examples of the benefits of physical activity for disease prevention and health promotion include improvements in body composition, aerobic capacity, overall physical fitness, blood pressure, blood sugar levels, and blood lipids, as well as mental health benefits such as enhanced self-esteem and self-confidence.

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For more information, please check: physical-literacy.isca.org

2.5.

Real world examples As real world examples, a set of “Good Practices” that were suggested by the different partners of the Moving for Health project are presented. In this case, “Good practices” refer to strategies that are recognized by partners as effective in achieving dissemination and education concerning the concepts of PL and HL, in the settings of sport clubs, schools, communities and health centres.

They are derived primarily from experience and modelling one of the following characteristics: Effectiveness, because they can illustrate the production of desired results; Efficiency, because they allow us to verify how to optimize the use of resources; Sustainability, illustrating how they can be maintained over time, respecting the environment or minimizing resources; Reproduction, in the sense that they can be replicated consistently in similar situations; Compliance with relevant regulations, standards and ethical guidelines; and Innovation to the extent that they incorporate new ideas and actions.

2.6.

Life span and environment (holistic conceptualisation)

Both PL and HL should be understood as contextually sensitive constructs that promote a long, active, and healthy life. The development of physical literacy allows for lifelong participation in physical activity. Health literacy is a personal asset that develops dynamically over time. A life-course approach to health literacy will allow for a better understanding of the mechanisms linking health literacy to health outcomes. Physical literacy can be understood as the alignment between an individual’s abilities and environmental factors, adapting to various contexts throughout their life. Physical literacy is important for lifelong physical activity and a healthy development of any human being. Health literacy is a context- and content-specific concept. Physical literacy challenges the conventional dualism that separates the body from the mind.

2.7.

Different approaches (environmental, family, organisational, multi-sector)

The scope of expression of PL and HL is multisectoral, involving many settings in a person’s life, of which sport clubs, schools, health centres and communities in general are very important examples. These environments are where PL and HL are expected to be demonstrated, making them essential spaces for fostering their development.

• An environment-oriented approach to HL and PL emphasises the role of the surrounding environment in shaping individuals’ health behaviours and physical activity. This approach moves beyond individual responsibility, recognizing that local infrastructure, national policies, and social norms significantly influence people’s opportunities to be active and make healthy choices.

For example, in educational settings, creating a task-solving or learning environment, rather than a competitive one, has been shown to enhance participants’ well-being and motivation. This approach fosters a social learning climate where autonomy is valued, allowing individuals to engage with physical activities in a way that suits their personal capabilities and preferences. For instance, integrating quality physical activity into the school day through active recess, classroom breaks, and physically active lessons has proven effective in improving students’ on-task behaviour, academic achievement, and overall physical activity levels.

• A family-oriented approach to HL and PL emphasises the crucial role that families, especially parents, play in shaping children’s health behaviours and engagement in physical activity from an early age. In the family environment, 8 | Moving for Health

parents act as “gatekeepers,” influencing their children’s physical activity, dietary behaviours, and sleep patterns through regulations and guidance. This influence is particularly significant during the early years of life when children are developing their autonomy and rely heavily on parental supervision.

Engaging families in the promotion of HL and PL is critical for the success of interventions, particularly in school settings. Research shows that when parents and siblings participate in physical activities together, it fosters a supportive environment that encourages children to engage in these activities consistently. This family involvement not only enhances the effectiveness of physical activity programmes but also strengthens the school-family-community relationship. A comprehensive approach to family engagement includes multiple strategies, such as active communication between schools and parents, encouraging volunteerism, and providing opportunities for families to support learning at home. Moreover, the inclusion of parents in decision-making processes and the integration of community resources further solidify the collaborative efforts needed to promote HL and PL. Tailoring these programmes to the specific needs and contexts of families is essential. A one-size-fits-all approach is unlikely to be effective, as each community and family has unique characteristics and challenges. Therefore, interventions should be customized to address the individual needs of the involved families, ensuring that the goals of HL and PL promotion are met in a meaningful and sustainable way.

• An organisational-oriented approach to HL and PL focuses on embedding these literacies within the structures, policies, and practices of institutions and organizations. This approach acknowledges that organizations, whether they are schools, health care providers, or workplaces, play a crucial role in shaping the health behaviours and literacy of the affected individuals.

For example, the West Vancouver School District in British Columbia, Canada, implemented a school-based physical literacy initiative that embedded mentors within the district to support elementary school teachers. This ongoing support structure is crucial for the sustained integration of physical literacy into the curriculum, ensuring that teachers have the necessary resources and guidance to effectively promote PL among students.

In the healthcare sector, the “Ten Attributes of Health Literate Health Care Organizations” model2, developed in the United States, provides a comprehensive framework for organisations to improve their health literacy practices. This model includes strategies such as integrating health literacy into planning, evaluation, and patient safety, as well as training the workforce to be health literate. By adopting such a strategic approach, health care organizations can significantly enhance their ability to meet the diverse health literacy needs of their populations, ultimately improving patient outcomes and satisfaction.

Workplaces also have a significant role to play in promoting HL and PL. For instance, in Poland, initiatives focused on promoting healthy eating and physical activity within the workplace have been recognized as effective strategies for improving employee well-being. Such programmes often involve creating supportive environments that encourage healthy behaviours, which can lead to long-term benefits for both employees and employers.

• A multi-sectoral approach to HL and PL involves the collaboration of various sectors — such as education, healthcare, community organisations, and urban planning — to address the diverse determinants of health and promote holistic well-being. This approach recognizes that health and physical activity 2

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Brach, C., Keller, D., Hernandez, L. M., Baur, C., Parker, R., Dreyer, B., Schyve, P., & Lemerise, A. J. (2012). Ten Attributes of Health Literate Health Care Organizations. nam.edu/wp-content/ uploads/2015/06/BPH_Ten_HLit_Attributes.pdf

are influenced by a wide range of social, economic, and environmental factors, and therefore require coordinated efforts across multiple disciplines and sectors.

One example of a multi-sectoral approach is the Physical Literacy for Communities (PL4C) initiative, which aims to establish community partnership tables that bring together stakeholders from different sectors, including schools, community programmes, and local governments. These partnership tables are designed to build capacity and support the delivery of community-based PL programmes, ensuring that efforts to promote physical literacy are integrated into various aspects of community life.

In a broader context, the concept of “Health in All Policies” (HiAP)3 embodies the essence of a multi-sectoral approach. HiAP emphasises the importance of considering health implications in all areas of policymaking, from urban planning to education, to create environments that promote health and wellbeing. This collaborative approach acknowledges that factors such as housing, employment, education, and the built environment significantly impact health outcomes, and that these factors must be addressed collectively to achieve comprehensive health promotion.

Research also supports the effectiveness of multi-sectoral approaches in improving health literacy. Studies have shown that HL is a key predictor of an active lifestyle and good indicator for the effectiveness of a health promotion programme. By incorporating HL into public health strategies, education systems, workplaces, and community organisations, a health-literate society can be nurtured, leading to better health outcomes and greater individual responsibility for health-related decisions.

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For more information, please check: cdn.who.int/media/docs/default-source/mca-documents/ rmncah/health-in-all-policies-key-messages-en.pdf?sfvrsn=a4982d1_#:~:text=Health%20in%20 All%20Policies%20(HiAP,the%20social%20determinants%20of%20health

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What really matters

The development of HL and PL must be based on a set of fundamental conditions or factors that signal what really matters for their promotion. These conditions and factors can be grouped into four broad subcategories: • Professionals are the drivers of change • Tailored approaches • Empowerment and awareness • Shared decision-making The need for learning and development of PL and HL in the general population implies the creation and development of training programmes in different life contexts. The preparation of professionals to assume this leadership must be a concern of society. For this purpose, the profile of these professionals must be discussed in terms of the competences they must develop. As for PL, in some countries’ educational systems, teachers are being trained for the use of proper programmes to increase the students’ PL. HL is creating new job opportunities and requirements to enhance the workforce with the development of HL as a professional skill. Considering the general growth in HL research and policymaking, HL is becoming a skill and competence demanded by the health system and authorities.

The specificities of people and their life circumstances imply that the promotion of PL and HL is carried out based on approaches adapted to these same characteristics or circumstances. Gender, age and stage of personal life (childhood, adolescence, adulthood and old age), socioeconomic condition and living conditions, personality characteristics (physical, psychological, emotional and social) and motivation to practice physical activity and health promotion, among others, are factors that shape people’s individual educational needs for the development of HL and PL. Leaders and educators must be aware of this to properly prepare and implement the different PL and HL improvement programmes. These approaches can be family-, organisation- (e.g., School, sport or health sector), or environment-based.

The idea of a development journey or pathway was developed, to support the design of different approaches to empowering and promoting awareness about PL and HL. The Health Literacy Pathway Model4 describes how HL develops along a trajectory that enables individuals supported by others to seek, engage with and act on health information to manage their health and become actively involved in health system consultations and informed decision-making. There are some proposals in the PL development stages which help leaders and educators understand that PL is a lifelong journey.

In the implementation of PL and HL development programmes, the sharing of knowledge, perceptions among stakeholders, namely leaders, technicians and users has been pointed out as a source of success of the same programmes.

Some experiences aim to integrate the knowledge pools of professionals’ medical knowledge and patients’ experiential knowledge when negotiating treatment in healthcare encounters. Some projects on PL created systems of self-assessment by which it is possible to promote the interaction between the user and the theorist or technician about PL knowledge or perceptions.

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Guide to health literacy by Council of Europe www.coe.int/en/web/bioethics/health-literacytools/-/highest_rated_assets/rPXyD7phSsK9/content/health-literacy-pathway-model-unitedstates#:~:text=The%20Health%20Literacy%20Pathway%20Model,consultations%20and%20 informed%20decision%2Dmaking.

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Sport clubs’ promotion

4. 1.

Overall principles to design sport clubs’ programmes To promote HL and PL in sports clubs effectively, it’s essential to follow a set of design principles that ensure the programmes are inclusive, comprehensive, and sustainable. These principles are grounded in the understanding that sport clubs play a crucial role in fostering healthy behaviours across different age groups and skill levels.

Here are the seven key principles that emerged from the reviewed literature: • Sport clubs should adopt a holistic view that integrates health promotion into all aspects of their operations, from administration to coaching. This approach ensures that health-enhancing behaviours are embedded into the club’s culture and practices, benefiting all members, regardless of their level of participation.

• Programmes should be designed to be inclusive, catering to various population groups, including children, seniors, women, and individuals with disabilities. This inclusivity ensures that everyone could participate and benefit from the health and physical activity programmes offered by the club.

• Recognizing that different groups have varying needs, sport clubs should offer tailored programmes that address the specific health and physical literacy requirements of their members. For example, youth programmes might focus on developing fundamental and functional movement skills, while adult programmes might emphasize maintaining fitness and preventing injury.

• Sport clubs should collaborate with other sport clubs and movement opportunity providers, external partners, including local health organizations, schools, and community groups, to enhance the reach and effectiveness of their health-promotion activities. These partnerships can provide additional resources and expertise, making the programmes more robust and impactive.

• The design and implementation of PL and HL programmes should involve regular evaluation and refinement. By continually assessing the effectiveness of their programmes, sport clubs can make data-driven adjustments that improve outcomes and ensure the programmes remain relevant and effective.

• Beyond physical activity, sport clubs should incorporate health education into their programmes. This could include workshops on nutrition, mental health, regeneration, hygiene, and overall health prevention (how to take care of the body), injury prevention, rehabilitation after injuries and return to the training process, providing members with comprehensive knowledge that supports their overall well-being.

• The club environment should be supportive, encouraging, and focused on enjoyment and personal growth rather than competition alone. A task-solving or learning-oriented environment fosters a positive experience, increasing motivation and long-term engagement in physical activities.

4.2.

Health promotion in sports clubs Health promotion is usually only one of the main activities pursued at a sport club. However, health promotion in sport clubs holds significant potential. Clubs can become ideal settings for promoting healthy lifestyles and reaching a broad population, from young athletes to senior members and have a global health impact.

Emerging evidence shows that PL may be a stronger predictor of adolescent HL than sports and exercise participation. Thus, prioritizing the development of PL and all its elements (e.g. social, physical, cognitive, emotional) rather than just physical activity and performance is crucial for long-term HL and lifelong engagement in physical activity, and should be considered by all coaches and sport club members (e.g. coaches, sport directors, families, …).

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Sport Clubs for Health (SCforH)5 – An example: The purpose of SCforH is to encourage sport clubs and national sports organizations to invest more in using the health potential of their particular sport. In practical terms, this means emphasizing and providing health-enhancing sports activities and incorporating health education and broader health promotion efforts within a sport club’s environment. Thus, sport organizations need to go beyond their focus on performance and adopt a comprehensive approach, integrating health promotion into all aspects of the club, from administration and communication to coaching and management. This holistic strategy should aim to achieve physical, social, and mental health benefits for all members.

Many barriers need to be removed to promote long-term athlete well-being and participation in physical activity for life. Some of those barriers are related to accessibility and inclusivity, developmentally inappropriate practices, lack of expertise and education from the coaches and sports agents, lack of facilities and/or equipment to offer the possibility to develop all dimensions of PL and the emphasis on winning often overshadowing the holistic development and HL of the athletes.

4.3.

Inclusive sports participation Inclusion in sport is non-negotiable: Everyone should have the opportunity to participate in quality sports and PL experiences.

However, for promoting PL and HL in sport clubs and positive youth development for ALL, some of the barriers are: • Not all sports facilities and programmes are accessible or welcoming to lowincome and non-traditional participants.

• Differences in developmental age are ignored when sport is organized using chronological age groups.

• Athlete preparation is geared to the short-term outcome (i.e. winning) and not to the developmental process.

• Parents and caregivers are not educated about long-term development and do not have the necessary information to make the best sport choices for their children.

• High drop-out rates • The focus on all dimensions of PL is not intentionally integrated into the sport experience.

Coaches and sport club members need to be aware of these barriers and how to overcome them to promote PL and HL to yield a positive athlete development.

First, accessibility must be assured. Next, the first experience is critical and must be positive. Coaches need to be prepared to be inclusive and to adapt the activities to all children’s needs. Personal factors also need to be considered by teachers: developing PL is critical for all individuals in early ages; children have sensitive development periods and not all have them at the same time which may mean that there are different critical periods in early life when social and cognitive skills, habits, coping strategies, attitudes, and values are more easily acquired.

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For more information, please check: www.scforh.info/

At the micro-level, the Ecological Dynamics Rationale might be used to develop an individual’s journey. Following, a scheme of the rationale is shown:

Figure 2: Non-linear pedagogy principles and how they can support physical literacy6

4.4.

Holistic and collaborative approach Sport clubs need to go beyond their focus on performance alone and adopt a comprehensive approach, integrating health promotion into all aspects of the club, from administration and communication to coaching and management, knowing that the level of awareness may differ between different actors. This holistic strategy should aim to achieve physical, social, and mental health benefits for all members.

Multilevel factors to consider are: personal factors and the micro levels (sport sessions), the club’s social and environmental contexts, club policies, managers, links with communities, sport clubs’ boards, sport system, and policy level.

The five key principles to a setting-based approach to promote health in sport clubs are: Implementing an approach that includes all club actions contributing to health, not just those centred on one behaviour or theme 2. Involving people of all levels at the sport club (participants, parents, coaches, managers, volunteers) in the actions and decision-making linked to health promotion 3. Involving external partners and local actors in the actions and decision processes linked to health promotion 1.

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6 Figure 2 can be found on: Rudd JR, Pesce C, Strafford BW and Davids K (2020) Physical Literacy – A Journey of Individual Enrichment: An Ecological Dynamics Rationale for Enhancing Performance and Physical Activity in All. Front. Psychol. 11:1904. www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2020.01904/full

4. Being conscious that promoting health is a continuous and cumulative process 5. Base actions on the specific needs of the sport club and its actors, according to the context of the club and local actors How to start and what to value? Some suggestions for a collaborative approach to promote PL and HL in and through clubs are: • Form a clear picture of the identity, context, and conditions of the club; • Understanding of the health-enhancing qualities of the respective sport; • Consider the policies for health promotion in clubs, the physical environment, the social environment, all club members (athletes, coaches,…)

• HL and PL, and the ability to act from coaches and all school members • Create links with community sectors of health and education, among others • The capacity to adapt, deliver, and evaluate the PL and HL initiatives in clubs is critical. Agents need to be educated to adopt an evidence-based approach and value HL promotion in addition to performance. This means assessment, monitoring, and research in all aspects of sport and physical activity, as well as health programming and practice); focus on the long-term development of the individuals.

• Collaboration between organizations, sectors, and systems to support the health promotion in sport clubs; system alignments (sport, health, education, higher education, teacher/coach).

4.5.

Open questions From the analysis we have just carried out, we can now reflect on important issues and strategies for disseminating and promoting PL and HL in the context of sport clubs. When it comes to promoting HL and PL in sport clubs, several open questions remain that require further exploration.

1.

2.

3.

4.

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One critical area of inquiry is how to effectively integrate HL and PL into the core operations of sport clubs in a way that resonates with diverse member groups. While there is evidence supporting the benefits of health-promoting activities within sport clubs, the best methods for engaging members across different age groups, genders, and abilities remain unclear.

Another open question concerns the role of technology in enhancing HL and PL. As digital tools become increasingly prevalent, understanding how to leverage these technologies to support literacy initiatives in sport clubs is essential. This includes exploring the potential for apps, online platforms, and other digital resources to provide personalized guidance and support for members.

The sustainability of HL and PL programmes within sport clubs also poses an important question. Long-term engagement and funding are crucial for the success of these initiatives, but how to ensure sustained interest and financial support over time is not yet fully understood.

Additionally, the impact of cultural differences on the adoption and effectiveness of HL and PL programmes in sport clubs across different regions and communities warrants further investigation.

Finally, the measurement of success in HL and PL initiatives remains a challenge. Developing reliable and valid metrics to assess the impact of these programmes on members’ health outcomes and overall literacy levels is a complex task that requires more research and innovation.

4.6.

Good practices In this section, you can find examples of good practices of PL and HL in sport organisations. For detailed information, please visit the website of the relevant practice.

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GOOD PRACTICE 1

SPORT CLUBS

Physical Literacy, Environmental Citizenship, and Sustainability Course by the University of Lisbon

AIM & OBJECTIVES: To provide knowledge and skills for creating and implementing projects and strategies that promote physical literacy and environmental citizenship within the communities where the trainees are based.

ADDED VALUE: The course includes modules on the history and concept of physical literacy, active citizenship, environmental literacy, public health, and the Sustainable Development Goals, integrating theoretical knowledge with practical application.

TARGET GROUP: Professionals in education, sustainability, health, sports, and municipal services

LESSONS LEARNED: The development of physical literacy is achieved through general education, physical education, sports, public health, and various cultural activities in society, contributing to the promotion of active and healthy lifestyles, participatory citizenship, and sustainable development.

KEY STAKEHOLDERS: University, municipality

DESCRIPTION: The programme integrates theoretical and practical components, emphasising hands-on learning and project development. It covers topics such as physical literacy, environmental education, public health, and sustainable development. The curriculum includes modules on active citizenship, environmental sustainability, and the use of technology to promote these competencies.

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RESOURCES & REFERENCES: www.fmh.ulisboa.pt/ensino/pos-graduacoes/ literacia-fisica-cidadania-ambiental-esustentabilidade

GOOD PRACTICE 2

SPORT CLUBS

Playing for Life activity cards

by Australian Sport Commission

AIM & OBJECTIVES: To develop in school-aged children a love of movement and physical activity that will encourage them to play for life

TARGET GROUP: School teachers, sports coaches

KEY STAKEHOLDERS: Children

DESCRIPTION: Playing for Life activity cards are designed for daily use by teachers and coaches. Aligned with the Australian Curriculum and the Australian Physical Literacy Framework, these game-based activities are easily adapted to different sports and help create a safe, inclusive and challenging environment for children.

ADDED VALUE: An easy-to-implement approach to integrating physical literacy into teaching.

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LESSONS LEARNED: If the lesson is well constructed students will not ask ‘When can we play the game?’ because they will already be engaged in game-related activities from the start.

RESOURCES & REFERENCES: www.sportaus.gov.au/p4l

GOOD PRACTICE 3

SPORT CLUBS

Movement preparation,

a physical literacy-enriched warm-up programme initiated by the Canadian Soccer Association, Sport for Life and the Public Health Agency of Canada

AIM & OBJECTIVES: Implementing the movement preparation programme instead of a traditional warm-up before training as a way of not only enhancing performance but also making it more sustainable.

TARGET GROUP: (football) Players or Sports Clubs in general

KEY STAKEHOLDERS: (football) Trainers

DESCRIPTION: The movement preparation programme was developed based on scientific findings to promote physical literacy and provide a warm-up not only focusing on the body but also on the mind and the sustainability (resilience and safety) of the training and the physical activity.

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ADDED VALUE: Can be specifically tailored to different sports and needs and can be implemented by sports clubs without any additional delays.

LESSONS LEARNED: A tailored warm-up based on the idea of physical literacy can improve skills and prevent injuries

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School promotion

5.1.

Overall principles to design school programmes To promote PL and HL in schools, comprehensive design principles that encompass the entire school environment should be considered. These principles ensure that health and physical activity are integral parts of the educational experience, contributing to a holistic development of students.

Here are some design principles that emerged from the reviewed literature: • A systemic, whole-school approach is crucial for embedding PL and HL into the fabric of the school culture. This involves integrating physical activity and health education into all aspects of the school day, from active recesses and classroom activity breaks to physically active lessons that tie into the broader curriculum. This approach ensures that every student, regardless of their physical abilities, has access to opportunities that promote movement and HL. • Quality physical education (PE) serves as the cornerstone for developing PL and HL in schools. It provides structured opportunities for students to acquire the knowledge and skills necessary to maintain a physically active lifestyle throughout their lives. Effective PE programmes are inclusive, offering challenges that cater to all levels of ability, and fostering a positive attitude toward physical activity.

• Schools should offer a variety of physical activities that are inclusive and appealing to all students, regardless of gender, physical ability, or cultural background. This can include traditional sports, creative movement activities, and non-competitive physical pursuits that encourage lifelong participation in physical activity.

• The involvement of all school staff, from teachers to administrative personnel, is essential in promoting a culture of health and physical activity. When school staff model active lifestyles and support health-promoting initiatives, they create a supportive environment that encourages students to engage in healthy behaviours as well.

• The engagement of families and the broader community is critical in reinforcing the values of PL and HL taught at school. Schools should facilitate active communication with parents, involve them in health and physical activity initiatives, and create opportunities for family and community participation in school-based health programmes.

• Schools must provide safe, supportive and diverse environments that encourage active participation in physical activities. This includes wellmaintained playgrounds, safe routes for active transportation to and from school, and inclusive spaces where all students feel comfortable engaging in physical activities.

5.2.

Whole-school approach A whole-school approach to promoting HL and PL is a comprehensive strategy that integrates health and physical education into all aspects of the school environment. This approach recognises that the school setting is a pivotal space for influencing students’ long-term health behaviours and literacy, and it aims to create a cohesive and supportive environment that prioritizes both HL and PL. At the core of the whole-school approach is the integration of physical activity and health education throughout the school day. This includes initiatives such as active recess, classroom physical activity breaks, and physically active lessons that are embedded within other subjects. These strategies not only increase students’ physical activity levels but also enhance their academic performance and on-task behaviour by making learning more dynamic and engaging.

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Quality PE is another essential component of the whole-school approach.

A well-structured PE programme provides students with the necessary knowledge, skills, and motivation to lead physically active lives. It serves as a foundation for developing physical literacy, ensuring that students are equipped to participate in a wide range of physical activities throughout their lives.

Quality PE also promotes inclusivity, offering challenges that are suitable for all students, regardless of their abilities.

The whole-school approach involves the active participation of all school staff, not just PE teachers. When teachers, administrators, and support staff model and support healthy behaviours, they reinforce the importance of HL and PL throughout the school community.

Family and community engagement are also critical elements of the wholeschool approach. Schools that actively involve parents and community members in health and physical activity initiatives create a stronger support network for students. This engagement helps to extend the impact of HL and PL education beyond the school walls, fostering a community-wide commitment to health.

Lastly, the whole-school approach emphasises the importance of creating adequate safety environments that encourage physical activity and healthy choices. This includes ensuring that school facilities, such as playgrounds and sports fields, are well-maintained and accessible, and that there are safe routes for active transportation to and from school.

5.3.

Quality physical education Quality PE plays a pivotal role in promoting both PL and HL within the school setting. As a foundational component of the educational curriculum, PE provides students with structured opportunities to develop the knowledge, skills, and attitudes necessary to lead healthy, active lives.

A key aspect of PE is its focus on inclusivity and the holistic development of each student. Rather than merely offering physical activity for its own sake, quality PE programmes are designed to foster a deep understanding of the value of physical activity and health. This includes teaching students the fundamental movement skills and competencies that form the basis of physical literacy. Through these programmes, students learn to appreciate the importance of physical activity for their physical, mental, and social well-being, which is essential for building lifelong habits.

Quality PE emphasizes the development of a positive relationship with physical activity. By creating an engaging and supportive environment, PE programmes can help students experience the joy of movement and the satisfaction of personal achievement. This positive experience is crucial in encouraging students to remain active throughout their lives, thereby promoting long-term PL. In addition to PL, quality PE also integrates HL by educating students about the broader aspects of health and wellness. This includes lessons on nutrition, mental health, injury prevention, and the importance of a balanced lifestyle. By combining physical activity with health education, quality PE helps students develop a comprehensive understanding of how their daily choices impact their overall health.

Another important feature of quality PE is its adaptability to the needs of diverse student populations. Effective PE programmes recognize that students come with varying abilities, interests, and cultural backgrounds. Therefore, quality PE offers a range of activities that cater to these differences, ensuring that all students can participate meaningfully and develop their physical and health

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literacy in a way that resonates with them personally.

Finally, quality PE serves as a model for other areas of the school environment, demonstrating how physical activity and health education can be seamlessly integrated into everyday school life. When schools prioritize quality PE, they create a culture that values health and well-being, encouraging students to carry these values with them beyond the classroom. Quality PE includes an adequate number of hours of PE per week. It is difficult to implement quality PE and development if you don’t have enough hours of PE per week.

5.4.

Family and community engagement The involvement of families and the broader community not only reinforces the lessons taught in schools but also creates a supportive network that extends the impact of these educational efforts beyond the classroom.

From the earliest stages of life, children are socialised within the family environment, where parents and caregivers serve as primary influencers of their behaviours and attitudes towards health and physical activity. When families are actively engaged in promoting PL and HL, they help to establish positive health behaviours that children are more likely to carry into adulthood. This engagement might include participating in family-oriented physical activities, modelling healthy behaviours at home, and supporting the school’s health and physical education programmes.

In schools, the integration of family and community engagement can take various forms. For instance, schools can create opportunities for parents to participate in health-related events, workshops, and activities, such as family fitness nights or nutrition education sessions. These events not only educate parents on the importance of PL and HL but also provide a platform for them to actively contribute to their children’s health education.

Schools can foster strong communication channels between teachers and parents, ensuring that families are informed about the school’s health and physical activity initiatives and understand how they can support these efforts at home. Effective communication helps align the goals of the school with those of the family, creating a cohesive approach to health and physical literacy.

Local health organizations, sports clubs, and community groups can partner with schools to offer programmes and services that enhance PL and HL among students. For example, community-led initiatives such as active transportation programmes (e.g., walking school buses) or after-school sports activities can complement the school’s efforts and provide students with more opportunities to engage in physical activity and learn about health in practical, real-world settings.

The collective efforts of families, schools, and communities create an environment where health and physical activity are valued and prioritized.

This collaborative approach not only enhances the effectiveness of PL and HL education but also ensures that students receive consistent messaging and support across all areas of their lives.

5.5.

Open questions From the analysis we have just carried out, we can now reflect on important issues and strategies for disseminating and promoting PL and HL in the context of schools. While significant progress has been made in promoting PL and HL within school settings, several open questions remain that need further exploration.

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1.

One of the primary open questions concerns the most effective ways to integrate PL and HL into the broader school curriculum. Although various approaches have been proposed — such as incorporating physical activity into academic lessons or using active breaks during the school day — the best practices for seamless integration that maintain academic rigor while promoting health remain unclear. Schools face the challenge of balancing educational demands with the need to provide students with sufficient opportunities for physical activity and health education.

2. Another important question relates to the inclusivity and accessibility of PL and HL programmes. Schools are diverse environments, with students from different backgrounds, abilities, and levels of interest in physical activity.

Understanding how to design programmes that are inclusive and engaging for all students, particularly those who may be less naturally inclined toward physical activity, is a critical issue.

3. Additionally, exploring how to adapt PL and HL initiatives to meet the needs of students with disabilities or those from underrepresented communities is essential to ensure equity in health education.

4. The sustainability of PL and HL programmes in schools is also a key concern. While many schools implement successful health initiatives, maintaining these programmes over the long term — amid changes in funding, staff, and student populations — can be difficult. Identifying strategies to ensure the continuity and evolution of these programs, even as school environments change, is crucial for their lasting impact. The lens of PL/HL may offer new views of the world, and give the possibility to create new questions/design principals which can be used as innovation tools 5. Lastly, as within other settings, measuring the success of PL and HL initiatives in schools presents its own set of challenges. Developing reliable and comprehensive metrics that accurately capture the effects of these programmes on students’ physical, mental, and social health is an area that requires further research. Understanding what constitutes success in these contexts and how to measure it effectively will help schools refine and improve their approaches.

5.6.

Good practices In this section, you can find examples of good practices of PL and HL in school settings. For detailed information, please visit the website of the relevant example.

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GOOD PRACTICE 4

SCHOOLS

Schools for Health in Europe

by Schools for Health in Europe Network Foundation

AIM & OBJECTIVES: To improve the health of children and young people in the European Region and Central Asia

TARGET GROUP: School authorities on national, regional and local level; Schools and practitioners on local level; Researchers and universities

KEY STAKEHOLDERS: Parents, local communities, health organisations

DESCRIPTION: SHE (Schools for Health in Europe) provides various resources related to school health promotion. These resources such as fact sheets on different health topics, conference statements, manuals and tools, health promoting school case studies and relevant literature about health promotion in schools.

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ADDED VALUE: The “SHE approach” encompasses a set of values, a specific perspective on the concept of health and a vision of health promoting schools as schools. These schools are characterised by implementing a structured and systematic plan to support the health and well-being of all pupils, as well as teaching and non-teaching staff.

LESSONS LEARNED: A whole-school approach acknowledges that every aspect of the school community influences upon students’ health and well-being, emphasizing the strong connection between learning and health.

RESOURCES & REFERENCES: www.schoolsforhealth.org

GOOD PRACTICE 5

SCHOOLS

Schools Committed to Sport and Health

by DES (Deporte para la Educación y la Salud)

AIM & OBJECTIVES: Training teachers for action and transformation of schools’ programme

ADDED VALUE: A well-tested method and a variety of resources to transform school practices

TARGET GROUP: Teachers

LESSONS LEARNED: Encouraging students to become more active and healthier is possible if the school commits to transformation

KEY STAKEHOLDERS: School authorities, regional governments, municipalities

DESCRIPTION: The programme combines scientific sources with resources from international projects, providing forty hours of training per academic year, along with an estimated forty hours of independent work for task development.

Its focus is on fostering an interconnected community of schools committed to sport and health, encouraging students to be more active, adopt healthy lifestyle habits, and benefit from a wide range of scientifically proven outcomes.

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GOOD PRACTICE 6

SCHOOLS

Play Biotopes – Where both children and nature thrive

by Swedish University of Agricultural Sciences

AIM & OBJECTIVES: to bring about a broader transformation of children’s outdoor environments, ensuring they function in harmony with nature while promoting children’s play and physical activity.

TARGET GROUP: School authorities, urban planners, community leaders, local governments

KEY STAKEHOLDERS: Children

DESCRIPTION: A play biotope is a specially designed area with conditions that encourage a wide variety of play and activities. The concept starts with nature, enhancing children’s opportunities to engage with landscapes, plants, animals, and other natural phenomena in a specific location.

Play biotopes are developed and tested in the Landscape Lab.

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ADDED VALUE: Design principles to develop sustainable and highly biodiverse play environments

LESSONS LEARNED: Highly biodiverse environments stimulate play while contributing to social and ecological sustainability.

RESOURCES & REFERENCES: movium.slu.se/media/u3slimj4/movium-fakta-32022-engelska.pdf

GOOD PRACTICE 7

SCHOOLS

Physical literacy enriched school transportation

by Change the Game

AIM & OBJECTIVES: To help develop Umeå as an active society by encouraging children and young adults to engage in healthier ways of getting to and from school.

TARGET GROUP: School students

KEY STAKEHOLDERS: School authorities, local government

DESCRIPTION: The pilot project aimed to find new forms of how children get to and from school in a physical literacy enriched way to promote sustainable development on many levels. Eight different units of movement were used to and from the school based on workshops with teachers and students.

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ADDED VALUE: One-off initiative that brings a sustainable advantage to a whole community

LESSONS LEARNED: The project made it clear that current recommendations for playground equipment limit the possibility of creating environments that develop physical literacy.

RESOURCES & REFERENCES: change-the-game.se/en/ physical-literacy-enriched-school-transportation

GOOD PRACTICE 8

SCHOOLS

Sharing Dance

by National Ballet School Canada

AIM & OBJECTIVES: To harness the transformative power of dance to improve lives.

ADDED VALUE: A leading example of designing high-quality movement experiences.

TARGET GROUP: Individuals with special needs

LESSONS LEARNED: Physical literacy provides valuable insights into the principles for leading and developing meaningful and impactful experiences for everyone, regardless of their level of competence or confidence.

KEY STAKEHOLDERS: Researchers, dance teachers

DESCRIPTION: The National Ballet School creates programmes and dance experiences tailored for children, seniors, and individuals with special needs, delivered both in-person and digitally.

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RESOURCES & REFERENCES: www.nbs-enb.ca/dance-for-life

GOOD PRACTICE 9

credits: University of Tartu’s Move Lab

SCHOOLS

Schools in Motion

by University of Tartu’s Move Lab

AIM & OBJECTIVES: To create a nationwide educational network of physical activity

ADDED VALUE: Comprehensive and flexible approach, based on co-creation

TARGET GROUP: Schools authorities

LESSONS LEARNED: Co-creation with schools and flexible design supports each schools’ motivation, autonomy, and unique identity.

KEY STAKEHOLDERS: School students, parents, community leaders, local government and health organizations

DESCRIPTION: A flexible framework for all participating school.

For school teams: systematic approach to the whole school day, start-up-day – inspiration, toolkits to integrate moving to school day, best practices, overview of research.

For teachers: training modules for active lessons, ready-to-use materials and web-based depository developed by co-creation process.

For pupils: recess activators training and materials. For network: school visits, exchangeof-experience seminars, network development seminars, online network.

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RESOURCES & REFERENCES: www.liikumakutsuvkool.ee

GOOD PRACTICE 10

SCHOOLS

Health Literacy Month event organised by SHAPE America – Society of Health and Physical Educators

AIM & OBJECTIVES: Skills-based health education to provide youth with knowledge and skills needed to make health-enhancing choices, ensuring that kids/ students have the ability to address their own health needs now and in the future.

TARGET GROUP: Students and main community (school age).

KEY STAKEHOLDERS: Teachers, community.

DESCRIPTION: Month-long event that includes workshops, classes addressing health and well-being issues, divided into 4 thematic weeks (skill-based health education, mental health, drug education and sex education in the health classroom).

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ADDED VALUE: The event is organised into well-defined blocks, providing a clear framework for structuring future programmes.

LESSONS LEARNED: The project was not only successful among its participants but, according to its website, also led to the formation of partnerships and the creation of resources (such as campaigns and tools) to improve health literacy. It also identified new topics to explore in future editions.

RESOURCES & REFERENCES: shapeamerica.org/events/Health_Literacy/ health_literacy_month.aspx?hkey=9a91db05e030-44b2- 8539-fbc6b92ab0fd

GOOD PRACTICE 11

credits: Sporty and Healthy

SCHOOLS

Sporty and Healthy international project co-funded by the European Union

AIM & OBJECTIVES: The project focuses on exchanging experiences and knowledge, seeking solutions to promote children’s sports activities.

TARGET GROUP: Children

KEY STAKEHOLDERS: Teachers, tutors, trainers and parents

DESCRIPTION: The project provides resources such as class scenarios, educational and communication materials, specialist consultations, webinars, and online classes. As part of the partnership, the programme has been prepared for teachers and parents who, by enrolling in the free programme, gain access to materials and tools to support education for a healthy lifestyle (including overweight and obesity, type 2 diabetes, posture defects prevention).

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Also, there are many scenarios for health-related activities available on the website as well as hints and tools how to organise a “Day of Sport”.

An important aspect of the project is raising awareness about the shift in approach to early sports specialisation and the conscious effort to minimize premature competition.

ADDED VALUE: Project with extensive materials providing information to empower stakeholders.

LESSONS LEARNED: Providing a certificate for each facility and coordinator confirming participation in the programme is a clear indication of commitment to the goals of the project.

RESOURCES & REFERENCES: healthyandsporty.eu

6.

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Community promotion

The integration of PL and HL within community settings plays a pivotal role in fostering a culture of health and well-being. These two literacies are interconnected, impacting various aspects of public life, from transportation to urban design. Promoting both is essential for sustainable community development. In our project, in the community setting, we explore the relevance of PL and HL across several topics, including active transportation, inclusive design, autonomy, intergenerational connections, community engagement, community-based partnerships, innovation, and sustainability. This document explores the significance of PL and HL in different domains, illustrating good practices for each and offering reflections on their contributions to achieving the Sustainable Development Goals (SDGs) in health, education, and community well-being.

6.1.

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Overall principles to design community programmes Here are some key principles to design a programme for community settings within the framework of the Moving for Health project, focusing on HL and PL: •

Active Transportation: Encourage walking, cycling, and other forms of active transport. This promotes physical activity, contributing to both physical health and social cohesion. High PL and HL support active transportation by empowering individuals as well as city planners and designers to value and choose health-beneficial travel options.

•

Inclusive Design: Ensure spaces are accessible to all, irrespective of age, ability, or socio-economic status. This allows for environments where people can engage in physical activity and access health information, boosting both PL and HL; connection and cooperation with other stakeholders like public administrations and local community is detrimental to this task and community engagement plans for infrastructure planning are needed.

•

Autonomy: Foster individual empowerment in health choices. Programmes that blend purposefully designed movement experiences with social and nutritional engagement help participants take charge of their health for extrinsic as well as intrinsic reasons.

•

Intergenerational Connections: Encourage programmes that involve multiple generations and promote physical activities, which supports knowledge sharing and relationship building. This can be significant for sustaining HL and PL across age groups.

•

Community Engagement: Involve community members in the design and implementation of health initiatives. This ensures that programmes are culturally relevant and resonate with local needs and interests.

•

Cross-sector Collaboration: Partner with various sectors and local organisations. Such collaborations leverage collective resources and expertise, enhancing programme effectiveness and sustainability.

•

Digital Innovation: Integrate new methods, including digital tools, to engage the community and facilitate access to health promotion. Digital interventions, such as eHealth, can improve health behaviours, particularly among parents and children.

•

Sustainability: Emphasise natural environments that offer both play value and ecosystem services. These are environments where play and landscape are intertwined. This ensures cost-effective programmes that contribute to long-term health, educational and environmental goals.

•

Assessment: Regularly evaluate programme effectiveness to ensure they meet community needs and reach set PL and HL promotion goals.

While the principles identified during the research phase provide a strong

foundation, drawing on the extensive experience of our experts working directly within the community setting, two additional principles were identified. These principles were not derived solely from the research phase but were developed to address unique challenges and opportunities encountered in the real-world practice:

6.2.

•

Physical Environmental Design: Validate and develop movement opportunities based on the holistic view of humans that PL and HL offer.

Ensure to provide for all, irrespective of abilities (physical, social, creative and psychological) and interests. That will build a society where all can meaningfully participate and thrive through movement.

•

Risk and Safety: Strive towards an adequate safety management, opposed to a maximal safety approach which might mean removing opportunities for challenging and thrill seeking play that is, however, crucial for development, especially for children.

Active Transportation Active transportation, such as walking and cycling, scooting or roller skating is crucial for enhancing PL by embedding movement into daily routines. This should also be taken into account during urban planning processes. Physical activity not only improves physical health but also contributes to mental wellbeing and social cohesion. HL complements this by empowering individuals to make informed decisions about their travel choices and understand the health benefits associated with active transportation.

INSPIRATION A guide: The Guía para Planificar Ciudades Saludables emphasizes designing urban environments that promote walking and cycling. By prioritizing these modes of transportation, urban planners can directly influence the physical literacy of the population, contributing to overall public health​. Please check this document in Spanish for further information.

6.3.

Inclusive Design An inclusive design ensures that spaces are accessible to all, irrespective of age, ability, or socio-economic status. This creates environments where people can engage in physical activity and access health information, boosting both PL and HL; connection and cooperation with other stakeholders like public administrations and local community is detrimental to this task and community engagement plans for infrastructure planning are needed.

INSPIRATION A tool: Using PL as a compass when designing physical environments for movement offers the possibility for the involved actors to ask more and new meaningful questions. The solutions seem to create more social value with less economic and ecologic resources. It enables higher local and circular use of competence and resources. For more inspiration, please check “Planning tool for Environmental Movement Opportunities” developed by Change the Game.

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INSPIRATION A health literacy survey: Switzerland participated in an international survey on the HL of its population. This survey took place simultaneously in other countries of the WHO Europe region. The results were published in the form of a national report. They are also designed to serve as the basis for future measures. The main focus should be on strengthening digital HL, navigational HL and specific population groups (socially and health-disadvantaged groups). Please check the Federal Office of Public Health, Switzerland page for further information.

6.4.

Autonomy Autonomy in HL and PL empowers individuals to take control of their well-being.

It fosters individual empowerment in health choices. Programmes that blend physical activity with social and nutritional engagement help participants take charge of their own health.

INSPIRATION A programme: The RITMO programme in Portugal exemplifies how combining physical activity, nutrition, and social engagement can promote autonomy in health management. By offering diverse activities tailored to different interests, the programme empowers participants to take an active role in their health​. Please check their website for further information.

INSPIRATION A development programme: The diffusion of innovations theory offers a new change and influence strategy that can lead to an increased return of investment and increased chances to succeed at the implementation of PL. The theory has its origins in communication sciences, where it explains how an idea or product gains momentum and spreads over time. Please check this development programme webpage created by Change the Game for further information.

6.5.

Intergenerational Connections Intergenerational connections are crucial for transferring knowledge and fostering relationships that enhance community well-being. It encourages programmes involving multiple generations in physical activities, which support knowledge sharing and relationship building. This is crucial for sustaining HL and PL across age groups.

INSPIRATION A national initiative: The Physical Literacy for Communities (PL4C) initiative highlights the importance of engaging parents and children together in PL promoting activities, which strengthens family bonds and promotes shared health knowledge​. These intergenerational connections ensure HL and PL are nurtured across the lifespan. Please check their website for further information.

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6.6.

Community Engagement Community engagement is at the heart of promoting PL and HL in this setting.

It involves community members in the design and implementation of health initiatives. This ensures that programmes are culturally relevant and resonate with local needs and interests.

INSPIRATION An initiative for youth: The Cuida-te+ programme in Portugal successfully enhanced health literacy among youth through community-based health education and promotion activities, leading to better health outcomes​. By involving local communities in health education and promotion activities, the programme has significantly enhanced HL among youth, leading to better health outcomes​. Please check their website for further information.

6.7.

Cross sectoral Collaboration Partnerships between different sectors and local organisations and building on local context and culture are essential for the success of HL and PL initiatives.

Such collaborations leverage collective resources and expertise, enhancing programme effectiveness and sustainability.

INSPIRATION A scientific paper: In Spain, the pilot programme of physical activity prescription in primary care in the Valencian Community illustrates the benefits of community-based partnerships. By linking primary care with local resources for physical activity, the programme improved the health and well-being of participants through increased PL​. Please read this scientific paper in Spanish for further information.

INSPIRATION An initiative for HL promotion: This initiative demonstrates an effective strategy for leveraging the influence of well-known personalities to promote HL, aligning with the MfH’s goals of community engagement and dissemination of best practices. By involving ambassadors, the programme increases the reach and impact of health literacy messages, providing a model that can be adapted to other contexts within the the MfH network. Please check this website for further information.

6.8.

Digital Innovation in Health and Physical Literacy Innovation involves integrating new methods, including digital tools, to engage the community and facilitate HL and PL. Digital interventions, such as eHealth, can improve health behaviours, particularly among parents and children

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INSPIRATION A systematic review: A systematic review on eHealth interventions for pre-schoolers underscores the potential of digital tools to enhance HL among parents, leading to better health behaviours in young children​.

Such innovations are critical for adapting health promotion strategies to modern lifestyles. Please check this website for further information.

6.9.

Sustainability in Health and Physical Literacy Initiatives Sustainability ensures that the benefits of HL and PL programmes are longlasting. It emphasizes environmental-friendly practices, like promoting ecofriendly playgrounds that foster PL. This ensures that programmes contribute to long-term health and environmental goals, therefore also being more cost-effective.

INSPIRATION A national study: The comparison of traditional and nature-based playgrounds shows how eco-friendly designs can promote PL while contributing to environmental sustainability. Integrating ecosystem services into playground design fosters PL in alignment with broader sustainability goals​. Please check this website for further information.

6.10.

Assessment of Health and Physical Literacy Initiatives Evaluating whether leaders achieve their goals can serve as a strategic parameter, aligning with the idea of using PL and HL as tools to achieve broader objectives. This involves regularly assessing the effectiveness of health and physical literacy initiatives to ensure they address the specific needs of the community and meet established HL goals.

Tools that are indicated below can help ensure that initiatives are based on empirical evidence and can be continuously improved.

INSPIRATION A tool: The use of the PPLA-O tool in Portugal demonstrates how systematic assessment can guide the development and refinement of PL programmes, ensuring they meet community needs and achieve desired outcomes. Please check this website for further information.

INSPIRATION Guidelines: This initiative exemplifies a comprehensive and accessible approach HL promotion. The structured categorisation of resources by life stages and health topics aligns with the MfH’s goals of providing tailored HL tools and information. The rigorous validation process ensures the reliability of the information, making it a valuable model for developing and disseminating effective HL resources in the MfH network. Please check this website for further information in Portugal.

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6.11.

Conclusion Integrating PL and HL into community planning and programming is essential for building healthier, more active, and sustainable communities. By focusing on active transportation, inclusive design, autonomy, intergenerational connections, community engagement, partnerships, innovation, sustainability, and assessment, we can create environments that support the well-being of all individuals. These efforts require collaboration across sectors and the active involvement of community members to ensure that the programmes are effective and sustainable in the long term. Such initiatives align with global goals for health, education, and sustainable development, offering a pathway to a more equitable and healthy future.

6.12.

Open Questions From the analysis we have just carried out, we can now reflect on important issues and strategies for disseminating and promoting PL and HL in the context of communities.

How can communities better engage marginalized populations in physical and health literacy initiatives?

1. How can communities better engage marginalised populations in PL and HL initiatives?

2. What role should local governments play in ensuring the sustainability of HL and PL programmes?

3. How can technology be leveraged to enhance both PL and HL in diverse communities?

4. In what ways can intergenerational programmes be expanded to foster deeper connections and shared knowledge between age groups?

These questions invite further exploration and discussion on the continued development and integration of PL and HL promotion in communities.

6.13.

Good practices In this section, you can find examples of good practices of PL and HL promotion in community settings. For detailed information, please visit the website of the relevant practice.

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GOOD PRACTICE 12

COMMUNITY

National Study of Playgrounds: An Observational Study of Play and Design initiated by the San Diego State University

AIM & OBJECTIVES: To examine the influence of design on use and physical activity in 60 playgrounds in the United States

ADDED VALUE: The findings provide valuable insights for landscape architects and other professionals aiming to design high-performance playgrounds.

TARGET GROUP: The general public using playgrounds, particularly children and parents

LESSONS LEARNED: Playground design significantly influences usage patterns and the overall benefits experienced by users.

KEY STAKEHOLDERS: Community leaders and city authorities

DESCRIPTION: he study observed nearly 34,000 playground users, gathering data on user behaviour related to play and recreation. It also documented changes in play behaviours, social interactions, and the duration of time users spent in these spaces over time.

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RESOURCES & REFERENCES: www.landscapeperformance.org/blog/2024/01/ National-Study-of-Playgrounds

www.studioludo.org/projects/ national-study-of-playgrounds

issuu.com/studioludoorg/docs/ nsopbooklet?fr=sM2I5NzM0OTA4MjQ

GOOD PRACTICE 13

COMMUNITY

Inner Development Goals (IDGs) & Quality Movement experiences initiated by Change The Game and the IDG Foundation

AIM & OBJECTIVES: To explore the IDG framework and design high-quality movement experiences that foster physical literacy making them more sustainable than general physical activity.

ADDED VALUE: Promotes physical literacy but also awareness of the need for a sustainable world in general

TARGET GROUP: General public (regardless of gender, age, fitness level, socioeconomic status, etc.)

LESSONS LEARNED: Enriched movement experiences were found to better develop the inner skills defined by the IDG Framework compared to traditional, basic physical activities

KEY STAKEHOLDERS: Researchers, advocates of physical literacy, community planners and sustainability strategists

RESOURCES & REFERENCES: change-the-game.se/wp-content/ uploads/2024/05/IDG-quality-movementexperiences_CTG2023.pdf

DESCRIPTION: In workshops, IDGs (an initiative designed to promote “skills and qualities to live purposeful, sustainable, and productive lives”) were used to create high-quality movement experiences. This was achieved by reflecting on the “differences between traditional physical activity and an enriched version, which is intentionally designed to sustain and strengthen the participants’ connection to movement and physical activity)”.

innerdevelopmentgoals.org/framework

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GOOD PRACTICE 14

COMMUNITY

Programa de Embaixadores da SPLS (Ambassador programme by SPLS) by the Portuguese Society for Health Literacy – Sociedade Portuguesa de Literacia em Saúde SPLS

AIM & OBJECTIVES: To promote health literacy through the involvement of prominent Portuguese personalities

TARGET GROUP: The Portuguese population

KEY STAKEHOLDERS: Portuguese personalities

DESCRIPTION: The ambassadors, recognised for their achievements and healthy lifestyles, engage in community initiatives to raise awareness about health literacy. The programme seeks to leverage their influence to disseminate health literacy messages and inspire positive health behaviours among the public.

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ADDED VALUE: This shows an effective strategy for leveraging the influence of well-known personalities to promote health literacy, improving community engagement and dissemination of best practices.

LESSONS LEARNED: By engaging ambassadors, the programme extends the reach and impact of health literacy messages, offering a model that can be adapted to vatious contexts.

RESOURCES & REFERENCES: splsportugal.com/events/ programa-de-embaixadores-da-spls/

GOOD PRACTICE 15

COMMUNITY

Inclusive Trail Design initiated by the Kootenay Adaptive Sport Association (KASA)

AIM & OBJECTIVES: Developing adaptive and inclusive mountain biking trail guidelines

ADDED VALUE: One-off initiative that brings a sustainable benefit to the entire community

TARGET GROUP: from active elderly, to toddlers on run bikes

LESSONS LEARNED: Physical literacy-enriched environmental design (PLEED) can help develop and validate bike trails (and more)

KEY STAKEHOLDERS: Community leaders, proactive mountain bikers

DESCRIPTION: “Kootenay Adaptive team members, along with partners, began a project which would see guidelines developed for adaptive Mountain Biking. Testing trails, talking with advocates, working with builders […]. Kootenay Adaptive’s mountain biking trail guidelines are meant for free public use, to help grow the sport. The intentional side benefit of adaptive mountain biking trails, is that these trails open mountain biking up to the greatest number of users possible.”

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RESOURCES & REFERENCES: kootenayadaptive.com/ adaptive-mountain-biking-trail-standards

youtu.be/fuqz8HzBlO4?si=wwgVWZD7XWJ8rdzp

GOOD PRACTICE 16

credits: Menorca Borina

COMMUNITY

Menorca Borina (Minorca move yourself) led by the Sports Medicine Department of the Sports Service of the Consell Insular de Menorca

AIM & OBJECTIVES: To promote physical activity and exercise to improve the population’s health, through the direct relation and cooperation of the areas of intervention.

ADDED VALUE: The programme is directed at a smaller group (island’s population), creating a local network of different stakeholders who should be working together.

TARGET GROUP: Menorca Island population, regardless of age.

LESSONS LEARNED: Acting in all areas of intervention is expected to result in global benefits for population health (contamination effect).

KEY STAKEHOLDERS: Everyone involved in the Island community and the areas of intervention.

DESCRIPTION: The programme is divided into four areas of intervention: educational (interventions directed at schools and primary education classrooms); community (actions encompassing different sectors of society, including the development of urban healthy walking routes and interventions related to sustained mobility); prescription of physical exercise (cooperation with Primary Care Centers for prescribing physical exercise to subjects with cardiovascular risk factors); and scientific-academic (continuing education activities for healthcare staff).

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RESOURCES & REFERENCES: esports.cime.es/Contingut.aspx?IdPub=7812

www.apunts.org/en-minorca-borinatmove-yourself-description-articuloX188665811762101X

GOOD PRACTICE 17

COMMUNITY

Development programme for early adopters initiated by Change The Game

AIM & OBJECTIVES: To assist project leaders (from all sectors) who have embraced physical literacy in developing new activities or environments, using physical literacy as a guiding principle.

TARGET GROUP: Project leaders (both non-profit and professional) and their communities.

KEY STAKEHOLDERS: Physical literacy experts DESCRIPTION: Leaders from ten different organisations/ activities in the Västerbotten region participated in the programme. All shared a vision of a society where everyone has the right to be active and were “early adopters” of physical literacy. With the support of advisers and educators, they had the opportunity to develop ideas that encourage more people to increase their ability, motivation, and opportunity to be active. Participants also exchanged experiences, gained in-depth knowledge of physical literacy, and had the chance to spread their new ideas and solutions.

The programme consisted of group meetings, individual sessions with facilitators, independent development work, and efforts to disseminate the new solutions.

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ADDED VALUE: Supports local physical activity projects, connects them, and promotes the concept of physical literacy.

LESSONS LEARNED: According to the diffusion of innovations theory, supporting early adopters enables them to create success stories and good examples that others can look to for inspiration. Successful early adopters then become advocates and role models.

RESOURCES & REFERENCES: change-the-game.se/en/ development-program-for-early-adopters

GOOD PRACTICE 18

COMMUNITY

FitBack initiated by the European Network for the Support of Development of Systems for Monitoring Physical Fitness of Children and Adolescents, University of Ljubljana

AIM & OBJECTIVES: The FitBack network develops tools to monitor the fitness levels of youth across Europe, collecting quantitative data (such as BMI, age, and physical activity level) to predict future trends in population health. Based on this data, the network prepares reports and guides on how to improve physical fitness.

TARGET GROUP: Children and youth

KEY STAKEHOLDERS: Community leaders and policy makers

DESCRIPTION: FitBack offers an interactive and comprehensive fitness map of Europe. It also provides users with guidance on how to conduct fitness tests, meet individual student needs, and design a physical fitness monitoring system.

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ADDED VALUE: One crucial aspect of health and physical literacy is understanding the current state through data.

FitBack stands out as an exemplary project in effective, research-based data collection.

LESSONS LEARNED: Using the right tools in a simple and clear manner provides valuable information for future research.

RESOURCES & REFERENCES: www.fitbackeurope.eu/en-us/about/ description-resources

GOOD PRACTICE 19

COMMUNITY

Physical literacy enriched public environments initiated by the Swedish Innovation Agency

AIM & OBJECTIVES: To use physical literacy as a compass when designing public movement environments, with the aim of driving change at the system level.

ADDED VALUE: A collaboration with the Umeå University has begun, with the goal of offering an academic course in physical literacy by 2024.

TARGET GROUP: The general public using public movement spaces, primarily children and young adults.

LESSONS LEARNED: Planning public environments with physical literacy in mind makes them more sustainable, which also benefits both ecological and economic outcomes.

KEY STAKEHOLDERS: Community leaders and city authorities.

DESCRIPTION: The project is divided into six work packages, each led by a different project partner. The work focuses on three main areas: (1) Innovations through positioning, (2) Innovations through product development, and (3) Knowledgeenhancing innovations.

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RESOURCES & REFERENCES: www.vinnova.se/en/p/ physical-literacy-in-public-environments/

change-the-game.se/wp-content/ uploads/2024/05/Planning-tool-based-onPLEED_Change-the-game-2023.pdf

7.

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Health Centres promotion

7.1.

Introduction Health centres play a pivotal role in promoting PL and HL. Through a combination of education and practical support, these centres contribute significantly to personal capacity building, lifelong learning, digital HL, social cohesion, and community activation. The overarching goal is to enhance both individual and collective well-being, a task that requires a multi-faceted and integrative approach. This document delves into the various strategies and initiatives that health centres can employ to foster HL, supported by examples of good practices from various HL and PL initiatives. The approach integrates strategies from individual to collective actions, ensuring the development of PL and HL across different communities. This framework is supported by examples of good practices from various initiatives and studies.

7.2.

Overall principles for Health Centres design The document outlines several key principles for designing a project that promotes HL and PL within health centres. Here’s a summary:

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•

Personal Capacity Building: Empower individuals with knowledge, skills, and attitudes for managing their health through educational support. Health centres can foster a nurturing environment to enhance individuals’ control over their health, emphasising personalised and collaborative approaches, which are essential for effective self-management.

•

Health literacy (HL), a dynamic concept that refers to an individual’s knowledge, perceptions and behaviour, based on a complex set of interactions regarding their health and illness.

•

Digital Health Literacy: As healthcare increasingly digitalises, digital HL becomes essential, ensuring that patients can access and navigate digital health resources confidently. Promoting accessibility, providing digital resources, and training healthcare workers are central to ensuring equitable healthcare for all, particularly those facing barriers.

•

Lifelong Learning: Continuous health education allows individuals to adapt to health changes over time. Health centres can support lifelong learning, collaborating with educational institutions and other community institutions to promote and increase both PL and HL throughout different life stages, ultimately fostering resilient communities, and to empower them so they can take better care of their own health.

•

Individual to Collective Action: HL should extend beyond individual empowerment to collective actions, enabling sustainable, communitywide health improvements. This involves building healthy and active movement habits that address mental health and fundamental needs through collaborative and supportive environments.

•

Social Cohesion: Promoting social cohesion within communities strengthens the effectiveness of HL and PL initiatives, building a sense of community and improving overall societal well-being and resilience.

•

Physical Literacy: PL involves developing the competence and confidence to engage in diverse physical activities, essential for overall health and well-being. Inclusive and comprehensive programmes that involve various stakeholders ensure a broad approach to promoting PL.

•

Evaluation and Assessment: Validated assessment tools support personal capacity building by enabling self-assessment and improvement in HL and PL. These tools contribute to evidence-based programming and help ensure the accuracy and effectiveness of initiatives.

These principles provide a foundation for designing and implementing effective HL and PL programmes within health centres, emphasising personal empowerment, digital accessibility, continuous learning, community involvement, and evidence-based assessment.

7.3.

Personal Capacity Building Personal capacity building is fundamental in empowering individuals to manage their health effectively. This involves empowering individuals with knowledge, skills, and attitudes for managing their health through educational support. Health centres can foster a nurturing environment to enhance an individuals’ control over their health, emphasising personalised and collaborative approaches, which are essential for effective self-management.

In this project, our work explores the nature and direction of the relationship between PL and HL to identify appropriate overall design principles.

INSPIRATION An article: Joint consultations between health professionals and patients are crucial in identifying personalised health interventions and to create personalised health action plans. This collaborative process enables individuals to receive tailored recommendations for activities that address their specific health needs. Please read the article here.

7.4.

Health Literacy HL is a dynamic concept that refers to an individual’s knowledge, perceptions and behaviour, based on a complex set of interactions regarding their health and illness. Health literacy encompasses the knowledge, motivation and competence individuals have that enable them to access, understand, appraise and apply health information in everyday decision-making processes concerning health promotion, disease prevention and health care. Besides general HL, specific health literacies such as communicative, navigational, vaccinationrelated and digital HL play an important role in today’s healthcare and society.

HL is not determined solely by the abilities of individuals within the population, but also by the responsiveness of the health system and its services7.

7

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Health literacy of Slovenian adults, 2022: nijz.si/wp-content/uploads/2022/12/porocilo_hls-si19_en.pdf

7.5.

Digital Health Literacy As healthcare increasingly digitalises, digital HL becomes essential, ensuring that patients can access and navigate digital health resources confidently.

Promoting accessibility, providing digital resources, and training healthcare workers are central to ensuring equitable healthcare for all, particularly those facing barriers.

Making healthcare accessible to everyone, especially those who face barriers, may be facilitated by improving HL. It suggests actions for governments and health providers like promoting digital health services (digital HL), involving policymakers assessing HL needs and training healthcare workers. (Council of Europe’s Steering Committee for Human Rights in the Fields of Biomedicine and Health (CDBIO))

INSPIRATION An article: Programmes like the Portuguese initiative that integrates mobile health units, youth health counselling offices, and interactive online platforms to promote healthy lifestyles among young people. The Portuguese programme uses digital tools to engage young people in health-promoting activities. Please find the article here.

INSPIRATION Best practice portal: Platforms like the Portuguese Society for Health Literacy (SPLS) provide valuable resources by identifying, evaluating, and disseminating best practices in health literacy through digital means. The SPLS platform, which offers access to best practices in digital health literacy, ensuring broad accessibility. Check the selected best practices on this website.

7.6.

Lifelong Learning on relationship between PL and HL Continuous health education allows individuals to adapt to health changes over time. Health centres can support lifelong learning, collaborating with educational institutions and other community institutions to promote and increase both PL and HL throughout different life stages, ultimately fostering resilient communities that can take better care of their own health.

Health centres should collaborate with schools and community organisations to promote PL and HL from childhood through adulthood. ​

INSPIRATION A research proposal: The “Do Passo ao Abraço” project, an integrated care initiative that promotes lifelong learning and community activation.

These programmes emphasise community involvement and lifelong learning by integrating care across various settings, ensuring continuous health education and activation. Please find the research proposal here

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7.7.

From an Individual to a Collective Action HL initiatives should transcend individual empowerment to encompass collective actions that enhance the health of entire communities. This approach ensures that health improvements are sustainable and widespread. The idea of public centres offering support in building healthy habits (personal capacity building) transferable and universal (from individual to collective), possibly by addressing mental health issues and enhancing support for basic psychological needs, contributes to the reflection in this project. Miguel Arriaga provides a strategic framework, offering a holistic approach to HL, aligning with the MfH’s objectives of integrating HL into various settings. Its focus on evidence-based strategies, stakeholder engagement, and continuous evaluation and offers valuable insights8. The four domains (physical, cognitive, emotional, social) of PL may be developed. Physical activity allows the passage from the individual to the collective, including participants with different levels, abilities, and interests.

Professional auto-evaluation, the plan’s emphasis on behavioural sciences, and the creation of health-promoting environments supporting the topic from individual to collective makes it a robust model for HL promotion.

INSPIRATION Guidelines: These guides promote the creation of healthy urban environments by encouraging citizen participation and collective action, which are vital for community health improvements. A guide that outlines strategies for creating healthier cities by involving citizens in collective health-promoting activities.

Please check the guidelines here.

7.8.

Social Cohesion Promoting social cohesion within communities strengthens the effectiveness of health and physical literacy initiatives, building a sense of community and improving overall societal well-being and resilience.

INSPIRATION An article: A holistic PL framework that supports collective health efforts across various dimensions. These frameworks address all dimensions of physical literacy (physical, cognitive, emotional, and social) and encourage collective participation in health-promoting activities. www.tandfonline.com/doi/epdf/10.1080/10413200.2024.2342323

7.9.

Physical Literacy PL involves developing the competence and confidence to engage in diverse physical activities, essential for overall health and well-being. Inclusive and comprehensive programmes that involve various stakeholders ensure a broad approach to promoting PL.

8

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Costa A, Feteira-Santos R, Alarcão V, Henriques A, Madeira T, Virgolino A, Arriaga M, Nogueira PJ. Health Literacy among Older Adults in Portugal and Associated Sociodemographic, Health and Healthcare-Related Factors. Int J Environ Res Public Health. 2023 Feb 25;20(5):4172. doi: 10.3390/ijerph20054172. PMID: 36901182; PMCID: PMC10002045.

INSPIRATION An article: A socio-ecological model that integrates physical literacy into broader health literacy initiatives engages various stakeholders in promoting physical literacy, ensuring that health literacy programmes are comprehensive and inclusive. These models engage various stakeholders in promoting physical literacy, ensuring that health literacy programmes are comprehensive and inclusive. Please find the article here.

7.10.

Evaluation and Assessment In order to develop targeted interventions, it is crucially important to study the links between HL and the social determinants of health, health status, health-related behaviour and the use of health care services. This enables the identifications of the population groups to which particular attention should be directed9.

Validated assessment tools support personal capacity building by enabling selfassessment and improvement in HL. These tools contribute to evidence-based programming and help ensure the accuracy and effectiveness of HL initiatives.

Reviews that provide validated tools for HL assessment are crucial in developing evidence-based HL programmes. The HL check-list offers a collection of such validated tools. The availability of these tools supports the development of evidence-based health literacy programmes.

INSPIRATION A systematic review: This systematic review offers validated tools for health literacy assessment, supporting evidence-based programme development. Access to the document here.

INSPIRATION A Tool: A collection of validated tools designed to enhance personal health literacy through self-assessment and capacity building help to identify, disseminate and transfer best practices to advance health literacy in the fields of health promotion, health care and disease prevention. These studies validate physical literacy instruments, ensuring accurate measurement and effective implementation of health literacy initiatives. Access to the toolkit here.

9

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Health literacy of Slovenian adults, 2022: nijz.si/wp-content/uploads/2022/12/porocilo_hls-si19_en.pdf

7.11.

Open Questions From the analysis we have carried out, we can now reflect on important issues and strategies for disseminating and promoting PL and HL in the context of health centres.

While significant progress has been made in promoting HL, several open questions remain: • How can the relationship between PL and HL be better understood and utilised in health promotion?

• What are the most effective strategies for integrating digital HL into existing healthcare systems?

• How can lifelong learning be sustained in rapidly changing health environments?

7.12.

Conclusion The promotion of HL and PL requires a multi-faceted approach that includes personal capacity building, digital HL within health literacy, lifelong learning, and collective action. By implementing these strategies within health settings and evaluating their effectiveness, we can enhance individual and collective wellbeing, contributing to healthier communities.

7.13.

Good practices In this section, you can find examples of good practices of PL and HL in the setting of health centres. For detailed information, please visit the website of the relevant practice.

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GOOD PRACTICE 20

credits: Together for health

HEALTH

Together for Health Programme in Slovenia by the National Institute of Public Health Slovenia AIM & OBJECTIVES:

It is a comprehensive programme of integrated prevention of chronic diseases that is available to all adult residents of Slovenia. The main objective is to empower people to take care of their own health, become more active and to improve the quality of life.

TARGET GROUP:

Trainers and sport club members, teachers and children, community leaders and citizens, health providers and patients

KEY STAKEHOLDERS:

Health education and health promotion centres in Slovenia

DESCRIPTION:

Group interventions – workshops are organised as below: • How fit am I 1? (aerobic endurance tests – 6-minute walk test, 2-minute step test) • How fit am I 2? (physical fitness tests for adults/ older people – aerobic endurance test and tests for flexibility, muscular strength and balance) • Let’s get moving (people workshop led by physiotherapists, where people are empowered for active living and independent safe and efficient exercise) • Health measure (multidisciplinary workshop, where people are empowered to lose weight in a healthy way)

• Individual interventions are used by patients/clients who need individual counselling or measurements.

Health professionals also perform individual screening interventions called How much can I still do? (screening for functional disability and screening for falls).

• Health education and health promotion centres also organise activities in local communities, according to their needs. Some of the activities are 2 km walk tests (aerobic endurance test), Nordic walking demonstrations, exercise classes etc.

ADDED VALUE:

This unique, over 20 – year-old prevention programme for adults is well-received in health care. Recognised by the WHO, it shows positive results (the progress is monitored by subjective and objective tools/methods).

It combines theory and practice and habit formation, also linking health care interventions with sustainable healthy local community activities.

LESSONS LEARNED:

At the end of the workshops, particularly after longer sessions, participants are in better shape (objective and subjective measurements at the beginning and at the end of workshops). There are more health and physically literate, empowered by the knowledge gained, and are able to maintain an active lifestyle.

They know how to seek accurate information and can always ask for help.

RESOURCES & REFERENCES:

www.skupajzazdravje.si/en/about-the-programme

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GOOD PRACTICE 21

HEALTH

Biblioteca de Literacia em Saúde (Health Literacy Library) by the National Health System – SNS

AIM & OBJECTIVES: The Health Literacy Library aims to promote access to health information, making people more autonomous regarding their health and the health of those around them

TARGET GROUP: General population – regardless of age

KEY STAKEHOLDERS: Community and health providers

DESCRIPTION: The Health Literacy Library collects, analyses, and disseminates health literacy resources.

Each resource undergoes validation by health literacy experts and includes a technical sheet.

The repository is organised by life stages and specific health topics, ensuring easy access and relevance.

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ADDED VALUE: Comprehensive and accessible approach to health literacy promotion, with rigorous validation process of sources used.

LESSONS LEARNED: This provides a very interesting guideline for the structure of a resource repository, as well as a visual organisation of topics.

RESOURCES & REFERENCES: biblioteca.sns.gov.pt

GOOD PRACTICE 22

HEALTH

Physical Literacy for Communities (PL4C) initiated by the Public Health Agency Canada & Sport for Life

AIM & OBJECTIVES: A long-term initiative aimed at supporting individuals and fostering healthy communities by promoting the development of physical literacy in children and youth across Canada.

TARGET GROUP: Children and youth

KEY STAKEHOLDERS: Community leaders and city authorities

DESCRIPTION: This project focuses on building community partnerships and fostering sector collaboration.

It aims to increase awareness of physical literacy in targeted populations, develop local capacity to support physical literacy initiatives, and boost physical activity within selected communities through the approach of “Educate, Train, and Sustain.”

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ADDED VALUE: This large-scale project tackles a very large population and is therefore highly effective and also sustainable.

LESSONS LEARNED: “Physical literacy brings everyone to the table.”

When national authorities take initiative and provide funding and guidance for local networks, it can move a lot!

RESOURCES & REFERENCES: physicalliteracy.ca/national-initiative

GOOD PRACTICE 23

HEALTH

A concept paper on health literacy by the Careum Center for Health Literacy, Zurich. On behalf of the Swiss Federal Office of Public Health

AIM & OBJECTIVES: Exploring and improving the health literacy of the Swiss population

TARGET GROUP: Entirety of the Swiss population

KEY STAKEHOLDERS: National authorities

DESCRIPTION: “Switzerland participated in an international survey on the health literacy of its population.

This survey took place simultaneously in other countries of the WHO Europe region. The results were published in the form of a national report.

They are also designed to serve as the basis for future measures”

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ADDED VALUE: Large-scale surveys yields a comprehensive overview of a countries state regarding awareness of its population of the concept of health literacy and allows international comparisons

LESSONS LEARNED: The results of the study show a clear need for action. The main focus should be on strengthening digital health literacy, navigational health literacy and specific population groups (socially and health-disadvantaged groups).

RESOURCES & REFERENCES: www.bag.admin.ch/bag/en/home/strategieund-politik/nationale-gesundheitspolitik/ gesundheitskompetenz.html

GOOD PRACTICE 24

credits: School of Health Association

HEALTH

School of Health initiated by the School of Health Association - Slovenia

AIM & OBJECTIVES: The main objective is to empower people socially, mentally and physically, for better quality of life, by carrying out morning outdoor exercise in all seasons.

ADDED VALUE: “The School of Health Association takes care of the physical and mental health of the individual as well as socialisation, which is an important factor for the quality of life.”

TARGET GROUP: General public (regardless of age, but with a special focus on adults and seniors)

LESSONS LEARNED: The programme combines theory and practice and helps with behaviour change habits, also links health care interventions with sustainable healthy local community activities. It is well received especially among elders.

KEY STAKEHOLDERS: Community leaders and citizens

DESCRIPTION: There are two main ways to achieve the goal: series of exercises according the “1000 movements” method (exercises compiled by neurologist Nikolay Grishin) that are to be performed standing up, in the morning and in social groups; and “breathe with nature”, mindfulness focused activities, like walking in nature, visualization and breathing exercises.

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RESOURCES & REFERENCES: solazdravja.com/en-presentation-of-the-schoolof-health-association/

GOOD PRACTICE 25

HEALTH

Mugiment,

a collaborative project to achieve an active Basque society launched by the Basque Country Government

AIM & OBJECTIVES: This project serves as a platform to promote physical activity through a network of over 120 organisations across the Basque Country.

It implements several action lines, including guidance services, parks, the eusfit initiative, and improved access to sports facilities.

TARGET GROUP: General population

KEY STAKEHOLDERS: Organizations from health, sport, education and local communities.

DESCRIPTION: The platform provides various types of information, organised according to action lines.

The core focus is the creation of local networks that help guide the population to the appropriate services or activities.

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ADDED VALUE: Mugiment not only highlights a network of local stakeholders but also offers a guide on how other municipalities can develop their own networks.

LESSONS LEARNED: Having a clear and structured local network has been shown to increase the number of local users engaging with the services and activities offered.

RESOURCES & REFERENCES: mugiment.euskadi.eus/iniciatives-mugiment/ webmug00-content/en/

8.

References Rudd, J. R., Pesce, C., Strafford, B. W., & Davids, K. (2020). Physical Literacy – a journey of individual enrichment: an ecological dynamics rationale for enhancing performance and physical activity in all.

Frontiers in Psychology, 11. Available on: doi.org/10.3389/fpsyg.2020.01904 Literacia Física, Cidadania Ambiental e Sustentabilidade – Faculdade de Motricidade Humana. Available on: www.fmh.ulisboa.pt/ensino/pos-graduacoes/ literacia-fisica-cidadania-ambiental-e-sustentabilidade Playing for Life. Australian Sports Commission. Available on: www.sportaus.gov.au/p4l Canadian Soccer Association, Sport for Life, & Public Health Agency of Canada. (n.d.). Movement Preparation. Available on: sportforlife.ca/wp-content/uploads/2017/04/MP-Coach-2016-1.pdf Physical Literacy. (2024). Movement Preparation – Physical Literacy. Available on: physicalliteracy. ca/education-training/movement-preparation SHE. Available on: www.schoolsforhealth.org Mårtensson, F., Litsmark, A., Wiström, B., Hedblom, M., Sang, Å. O., & Movium Fakta. (2022). PLAY BIOTOPES – WHERE BOTH CHILDREN AND NATURE THRIVE. Available on: movium.slu.se/media/ u3slimj4/movium-fakta-3-2022-engelska.pdf Physical literacy enriched school transportation – Change the game.

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Available on: innerdevelopmentgoals.org/framework National Study of Playgrounds: An Observational Study of play and design. (2024) Landscape Performance Series. Available on: www.landscapeperformance.org/blog/2024/01/ National-Study-of-Playgrounds The National Study of Playgrounds.

Available on: issuu.com/studioludoorg/docs/nsopbooklet?fr=sM2I5NzM0OTA4MjQ Programmea de Embaixadores da SPLS, Portugal.

Available on: splsportugal.com/events/programmea-de-embaixadores-da-spls Adaptive Mountain Biking Trail Standards | Kootenay Adaptive. (2022). Kootenay Adaptive Sport Association. Available on: kootenayadaptive.com/adaptive-mountain-biking-trail-standards Engineering Health Team. (2022). Janis Neufeld Presentation Parks Accessibility Conference 2022 [Video]. YouTube: www.youtube.com/watch?v=fuqz8HzBlO4 Programmea Menorca Borina. Menorca Illa De L’Esport.

Available on: esports.cime.es/Contingut.aspx?IdPub=7812 Fernando, S. P., et al. (2017). “Minorca borina’t (move yourself)”: Description of a programme to promote physical activity and exercise for improving health in the island of Minorca. Apunts Sports Medicine. Available on: www.apunts.org/ en-minorca-borinat-move-yourself-description-articulo-X188665811762101X Development programme for early adopters – Change the game.

Available on: change-the-game.se/en/development-programme-for-early-adopters/ Description & Resources. FitBack.

Available on: www.fitbackeurope.eu/en-us/about/description-resources

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Physical literacy in public environments.

Available on: www.vinnova.se/en/p/physical-literacy-in-public-environments Vrdelja, M., Vrbovšek, S., & Berzelak, N. (2022). Health literacy of Slovenian adults: Results of the Slovenian Health Literacy Survey (HLS-SI 19), Available on: nijz.si/wp-content/uploads/2022/12/porocilo_hls-si19_en.pdf Fariña Tojo, J., Higueras García, E., Román López, E., & Pozo Menéndez, E. (2023). Guía para planificar ciudades saludables. Departamento de Urbanística y Ordenación del Territorio, Universidad Politécnica de Madrid. Available on: Guía para planificar ciudades saludables Change the Game (2023). Planning tool based on PLEED. Available on: change-the-game.se/wp-content/uploads/2024/05/Planning-tool-based-on-PLEED_ Change-the-game-2023.pdf Federal Office of Public Health FOPH. Health Literacy. Available on: www.bag.admin.ch/bag/en/ home/strategie-und-politik/nationale-gesundheitspolitik/gesundheitskompetenz.html RITMO: uma experiência sensorial na atividade física, alimentação e bem estar. SPLS Portugal. Available on: splsportugal.com/events/ ritmo-uma-experiencia-sensorial-na-atividade-fisica-alimentacao-e-bem-estar Development programme for early adopters – Change the game.

Available on: change-the-game.se/en/development-programme-for-early-adopters Physical Literacy. (2024). Physical Literacy for Communities—Public Health Agency of Canada Project – Physical Literacy. Available on: physicalliteracy.ca/national-initiative Rodrigues, F. (2021). Cuida-te+. O programmea que te ajuda a encontrar uma melhor saúde Tweet Whatsapp. Available on: www.forum.pt/ipdj/ cuida-te-o-programmea-que-te-ajuda-a-encontrar-uma-melhor-saude Martín-Doménech, A., Peiró-Pérez, R., Esplugues, A., Castán, S., Legaz-Sánchez, E., Pérez-Sanz, E., & Grupo de investigación Conecta Actius per a la Salut (Grupo CAS). (2020). Valoración de un programmea piloto de prescripción de actividad física en atención primaria en la Comunitat Valenciana. Atención Primaria, 52(10), 698–705. Available on: doi.org/10.1016/j.aprim.2020.05.001 National Study of Playgrounds: An Observational Study of Play and Design. (2024).

Landscape Performance Series. Available on: www.landscapeperformance.org/blog/2024/01/ National-Study-of-Playgrounds Martins, J., Onofre, M., & Dudley, D. (2024). Editorial: Health and physical literacy interventions in education, sport, and public health settings. Frontiers in Sports and Active Living, 5.

Available on: doi.org/10.3389/fspor.2023.1353743 Escola Nacional de Saúde Pública. (2021). Linhas orientadoras para a promoção da literacia em saúde: Produção, disponibilização e aplicação de recursos. Available: biblioteca.sns.gov.pt/wpcontent/uploads/2018/02/Boas-pra%CC%81ticas-de-prduc%CC%A7a%CC%83o-de-recursos-deapoio-literacia_parte-1_Fev2018-1.pdf National Study of Playgrounds. (2023). STUDIO LUDO. Available on: www.studioludo.org/projects/national-study-of-playgrounds Change the Game. (2023). Inner Development Goals and quality movement experiences. Available on: change-the-game.se/wp-content/uploads/2024/05/IDG-quality-movement-experiences_ CTG2023.pdf Fernando, S. P., Virgina, D. S., A, M. F. M., & Bernat, A. F. (2017). “Minorca borina’t (move yourself)”: Description of a programme to promote physical activity and exercise for improving health in the island of Minorca. Apunts Sports Medicine. Available on: www.apunts.org/ en-minorca-borinat-move-yourself-description-articulo-X188665811762101X Physical Literacy for Life Project, available on: physical-literacy.isca.org/

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D2.1. Research with principles, resources, strategies and initiatives for 4 targets has been developed in the Moving for Health Project under the Work Package 2Building a MOVING for HEALTH Network and mapping of current resources, strategies, and initiatives for MOVING for HEALTH model

WP2 leading organisation: EUPEA and co-lead by Human Kinetics Faculty (FMH), Lisbon

Project is funded by the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the European Education and Culture Executive Agency (EACEA). Neither the European Union nor EACEA can be held responsible for them.