Prevention 1st by state mandate – Health promotion as an overarching educational goal and teaching principle in primary school curricula: A comparison between Austria, Germany and Switzerland

Introduction thus, it is one of the major topics of our time. In line with the United Nations Sustainable Development Goals (UN SDG’s), especially Goals #3 “Good Health and Well-Being” and #4 “Quality Education” (United Nations Department of Economic and Social Affairs, 2022), the link between health and education is emerging as a focal point for the future of mankind. According to the World Health Organization (WHO; 2023), non-communicable diseases (NCDs) like cardio-vascular disease, cancer, or diabetes type 2 cause 74% of all deaths worldwide; the main risk factors promoting NCD development include unhealthy lifestyles, such as insufficient physical activity (PA) and/or poor dietary patterns. According to the WHO Health Behaviour of School-aged Children study, only 19% of all girls and boys in Europe and Canada meet the WHO’s physical activity recommendations (at least 60 min/day; WHO 2020). In addition, 1 in 5 adolescents are overweight/obese, and the diet of most adolescents does not meet current recommendations (Inchley et al., 2020). Since exercise and food are each considered medicine, regular PA A-Austria; CH-Switzerland) region for the first time regarding a 1-dimensional versus a dual health approach in the context of PA however, representative for the 16 federal states all over Germany the Bavarian curriculum was selected as best match for socio-cultural and geographical characteristics. Within 4 specific umbrella term-categories (a – PA b – nutrition; c – health; d – sustainability), related keywords were searched for in the respective documents. The basic data or hits were processed by using a didactical tool with distinct inclusion and exclusion criteria (“Ampelsystem”; Troppe et al. 2024). By applying this matrix, the basic data were refined one step at a time (number of hits, quantitative matches, qualitative matches via contextual verification) with the results matching from red over yellow to green categorization. Results (1) All primary school curricula analyzed for the DACH region include a 1-dimensional health approach with a main focus on the lifestyle factor PA Figure 1). (3) Only the German primary school curriculum contains at least one mention regarding a dual health approach. Discussion The most important finding of this study is that by state mandate, the compulsory subject Physical Education backed up by PA while the latter holds enormous potential left untapped and often neglected (not only to promote an active lifestyle but rather to empower the young for lifelong healthy lifestyles based on the 6 interwoven and related lifestyle areas), a 1-dimensional approach to health in the long-term seems insufficient to maintain health over the lifespan since health is rather a complex state. Therefore, the promising dual approach to sustainable health is recommended as a minimum and starting point in educational settings up to the tertiary level. Thus, the implementation of the dual approach as a minimum recommendation for sustainable health and health promotion ­is to be advocated in view of the health benefits of combined lifestyle factors (Troppe, 2024; Wirnitzer, n.d.). References Inchley, J., Currie, D., Budisavljevic, S., Torsheim, T., Jåstad, A., Cosma, A., Kelly, C., & Arnarsson, Á. M. (2020b). Spotlight on adolescent health and well-being: Findings from the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey in Europe and Canada. International report. Volume 1. Key findings. WHO Regional Office for Europe. https://www.who.int/europe/publications/i/item/9789289055000 Troppe, I., Tanous, D. R., & Wirnitzer, K. C. (2024). Bewegung & Sport im Lead der schulischen Gesundheitsförderung – Ein systematischer Review der Primarstufen-Curricula in der D-A-CH Region im Kontext des Pflichtfächerkanons Physical activity & sport in the lead of school health promotion - A systematic review of primary school curricula in the D-A-CH region in the context of the compulsory subject canon. Bewegung & Sport, 2024(2), 7-12. United Nations Department of Economic and Social Affairs. (2022). The sustainable development goals report 2022. United Nations. https://doi.org/10.18356/9789210018098 Wirnitzer, K. C. (n.d.). From science 2 school. https://www.science2.school/en/ World Health Organization. (2020). WHO guidelines on physical activity and sedentary behaviour. https://iris.who.int/bitstream/handle/10665/337001/9789240014886-eng.pdf World Health Organization. (2023). Noncommunicable diseases. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases