The everyday challenges of conducting health education that actually affects health knowledge,

health behaviour and health attitudes are complex. It is often difficult to present health in ways children and adolescents accept as relevant and meaningful. This often results in misconceived campaigns and approaches with little or no effect in terms of acquisition of health knowledge or changes in health behaviour. Many campaigns and approaches only manage to appeal to the children and adolescents who are already healthy (Grabowski, 2013a & 2013b). This presentation proposes a practice-oriented methodological combination of knowledge, participation/involvement and identity – as a new way of dealing with this challenge.

There are many approaches to health education in school that deal with the same basic challenges concerning how to present health knowledge in ways that make the students want to actually use this knowledge. An example of an education programme focusing on the link between health knowledge and health behaviour is found in Prelip et al.’s evaluation of a school-based multicomponent nutrition education programme to improve young children’s fruit and vegetable consumption (Prelip et al., 2012). Although the study showed that the programme influenced knowledge and attitudes, no significant increase in the students’ fruit and vegetable consumption was observed. This represents a classic and widespread challenge within health education: How do we get from knowledge to behaviour.

Closely linked to how children and adolescents are able to relate to health knowledge is the issue of participation/involvement, which has been a key concept in health education for several decades. Among the most widely used participation approaches is Hart’s theory about the ladder of participation, which describes various levels from token participation to genuine participation. Directly related to identity, Hart writes: “Most important in thinking about young people’s participation is the sequence of phases in perspective-taking, and the insight that the child is actively trying to construct the world of the other, while simultaneously constructing her own understanding of that world” (Hart, 1992: 32). Also on the subject of participation, Wilson, in her case study of health education in a secondary school, is able to conclude that “pupils who actively participate experience beneficial outcomes including increased confidence and improved relationships” (Wilson, 2009:100). These outcomes are then linked to benefits for both academic achievement and health-related decision-making.

With regards to actively using a concept of identity in education, Harrell-Levy and Kerpelman discuss the teacher’s role as an agent of identity formation using transformative pedagogical approaches. Harrell-Levy and Kerpelman claim that the role of the teacher is completely missing from the discussion of adolescent identity development, and argue “that a transformative approach as a purposefully designed effort to promote healthy identity development and positive student outcomes in academic, social, and emotional areas of their lives should be the rule rather than the exception in the typical middle school and high school classroom” (Harrell- Levy & Kerpelman, 2010:87). They go on to connect identity and learning to participation and involvement: “The more students are engaged in a meaningful way, the more they feel empowered to think critically and take ownership of their learning. This empowerment that can result from transformative pedagogy may serve as a protective factor for adolescents ordinarily at risk for dropout and other negative outcomes” (ibid:88).

This presentation discusses the interrelatedness of knowledge, involvement/participation and identity as a form of pedagogical coherence that is essential to health education practice and research. In a given health education initiative a focus on any of these three elements entails better conditions for working with the other two. The presentation will include empirical examples to demonstrate this.

Grabowski, D. (2013a) Identity, knowledge and participation: Health theatre for children. Health Education. Vol. 113, No. 1: 64-79. Grabowski, D. (2013b) Health-identity, participation and knowledge: A qualitative study of a computer game for health education among adolescents in Denmark. Health Education Journal. Vol. 72, No. 6: 761-768. Grabowski, D. & Rasmussen, K.K. (2014) Authenticity in health education for adolescents: A qualitative study of four health courses. Health Education, Vol. 114, No. 2: 86-100. Harrell-Levy, M.K. & Kerpelman (2010) Identity Process and Transformative Pedagogy: Teachers as Agents of Identity Formation. Identity, Vol. 10, No. 2: 76-91. Hart, R. (1992), Children’s Participation: From Tokenism to Citizenship, UNICEF International Child Development Centre, Florence. Prelip, M., Kinsler, J., Thai, C.L., Erausquin, J.T. & Slusser, W. (2012) Evaluation of a School-based Multicomponent Nutrition Education Program to Improve Young Children’s Fruit and Vegetable Consumption. Journal of Nutrition Education and Behaviour. Vol. 44, No 4: 310-318. Wilson, L. (2009) Pupil Participation: Comments from a case study. Health Education. Vol 109, No 1: 86-102.