In school-based approaches to health education, it is often difficult to present health messages in ways children and adolescents accept as relevant, authentic and meaningful (Grabowski, 2013a; Grabowski & Rasmussen, 2014a; Wistoft, 2010). This often results in misconceived campaigns and approaches that have little or no effect on acquisition of health knowledge or changes in health behaviour. More often than not, such campaigns and approaches only manage to appeal to children and adolescents who are already healthy, and therefore there is a risk that they will serve to increase the difference between those who are healthy and those who are not (Peters et al., 2009; Grabowski, 2013b; Grabowski & Rasmussen, 2014b).

Much of the literature on how to approach health education in school deals with the basic challenges concerning how to present health knowledge so that pupils will want to make use of this knowledge. Prelip et al. evaluate a school-based multicomponent nutrition education programme intended to increase young children’s fruit and vegetable consumption (Prelip et al., 2012). Although this study shows that the programme did influence knowledge and attitudes, no significant increase in pupils’ fruit and vegetable consumption could be observed. This represents a classic and persistent challenge within health education: How can we proceed from knowledge to concrete action, and what concept or procedural element constitutes the missing link? This presentation suggests that health identity could be this missing link – both in practice and in theory.

A way to address these challenges is to look at the role identity plays in health education. Identity is rarely used as an active concept within health education. Implementing a concept of identity within health education poses two main challenges, which are addressed in the objectives of this presentation: to theoretically and empirically develop a concept of health identity, and to apply this theoretical innovation to health education practice. Against the backdrop of these challenges and objectives and based on empirical studies (Grabowski 2013a & 2013b; Grabowski & Rasmussen, 2014a & 2014b), the presentation presents the following definition of health identity: “Children’s and adolescents' observations and expectations concerning their own health, their knowledge about health and in what ways their health is related and comparable to the health of others.”

Implementing an identity concept in health education research does however present several challenges. Bendle describes how the increased focus on identity renders use of the concept “inconsistent, under-theorized and incapable of bearing the analytical load required” (Bendle, 2002: 1). Hall focuses on a paradoxical development in recent years, where both a discursive explosion in use of the concept of identity and growing criticism of it have resulted in a kind of conceptual deconstruction. Hall indicates that many identity-concepts are no longer useable or good for thinking with in their original and unreconstructed form, and that because there are no new conceptual innovations, there is nothing to do but continue to think with them (Hall, 2001).

Attempts at relating health to identity are often restricted to research on experiences with serious illness. This makes sense, as chronic illness represents an identifiable disruption of normality that can be explained relatively straightforwardly using theory on identity crisis (e.g., Karnilowicz, 2011; Vickers, 2012). Another example of this tendency is found in the psychiatric research on illness identity – often defined as the set of roles and attitudes a person develops in relation to having a mental illness (e.g., Yanos et al., 2010). When it comes to health education, identity is an undervalued concept, as there are no examples of researchers employing a concept of identity as the central part of a health education research project.

Bendle, M.F. (2002) The crisis of 'identity' in high modernity. British Journal of Sociology. Vol. 53, no. 1, 1-18. 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. (2014a) Authenticity in health education for adolescents: A qualitative study of four health courses. Health Education. Vol. 114, no. 2, 86-100. Grabowski, D. & Rasmussen, K.K. (2014b) Adolescents’ health identities: A qualitative and theoretical study of health education courses. Social Science & Medicine. Vol. 120, 67-75. Hall, S. (2001) Who Needs Identity? In du Gay, P., Evans, J. & Redman, P. (Eds) Identity: A Reader, Sage Publications Inc, London, 15-33. Karnilowicz, W. (2011) Identity and psychological ownership in chronic illness and disease state. European Journal of Cancer Care. Vol. 20, 276-282. Peters, L.W.H., Wiefferink, C.H., Hoekstra, F., Buijs, G.J., ten Dam, G.T.M. & Paulussen, T.G.W.M. (2009) A review of similarities between domain-specific determinants of four health behaviors among adolescents. Health Education Research. Vol. 24, no. 2, 198-232. 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. Vickers, N. (2012) Narrative identity and illness. Journal of Evaluation in Clinical Practice. Vol. 18, 1070-1071. Wistoft, K. (2010) Health Strategies and reservoirs of knowledge among adolescents in Denmark. Global Health Promotion. Vol. 17, no. 2, 16-24. Yanos, P.T., Roe, D. & Lysaker, P.H. (2010) The Impact of Illness Identity on Recovery from Severe Mental Illness. American Journal of Psychiatric Rehabilitation. Vol. 13, no. 2, 73-93.