Effective Elements of School-based Provision for the Promotion of Healthy Lifestyles: A European Delphi Study

orsening health behaviors of children pose a significant public health problem. 1 In the past, youth-based health efforts focused on controlling and preventing infectious diseases, such as smallpox and tuberculosis. 2However, current health challenges increasingly relate to non-communicable diseases and associated behavior and lifestyle choices, including physical inactivity and poor diet. 3Rising levels of obesity and overweight are, perhaps, the most commonly cited evidence of these concerns, with more than 50% of the European Union population estimated to be overweight, and nearly one in 6 children overweight or obese. 4An array of comorbidities, such as high blood pressure, diabetes, and mental health issues, both during youth and later life, and associated health costs, 5 means that declining health adversely impacts individuals and communities.These trends emphasize the need for early intervention through comprehensive health promotion and primary prevention strategies.Schools have frequently been suggested as valuable settings to address this situation, creating a unique opportunity to reach children across the population during a critical period in developing and establishing health behaviors. 6However, implementation has often proved to be a challenge.