The school subject Physical education (PE) and its role within the broader public health work have long been a subject of discussion. Academic studies revolving around the health benefits of PE can broadly be categorized as being rooted in either a biomedical or resource-based health perspectives (Mong & Standal, 2019). In short, these perspectives represent different views on the question of ‘what’ health is, and subsequently on ‘why’ health should be part of PE and ‘how’ it should be taught. In the biomedical perspective health is understood as absence of disease and the ‘what’ of PE is often narrowed down to maximizing levels of moderate and vigorous physical activity. The ‘why’ becomes prevention of various non-communicable diseases. The ‘how’ is then dominated by instructional methods of pre-determined content developed by experts (Mong & Standal, 2019). On the other hand, a salutogenetic or resource-based health perspective are proposed to highlight and broaden the educative potential of PE (Quennerstedt, 2008). In this line of research health is understood as a collective and individual resource, and the ’why’ shifts from the preventing of risks to the nurturing assets for health. The ‘how’ is often described in terms of student-active and inquiry-based or critical didactical approaches, and a much broader array of skills, attributes and knowledge can be explored for the ‘what’ of health in PE.

Critical Health Literacy (CHL) is often put forward as a promising conceptual framework for health education (Nash, Patterson, Flittner, Elmer, & Osborne, 2021; Peralta, Rowling, Samdal, Hipkins, & Dudley, 2017). The concept have roots within emancipatory critical pedagogy (Freebody & Luke, 1990; Freire, 1970; Nutbeam, 2000) and consists of three overlapping and interconnected domains, (CHL-A) information appraisal, (CHL-B) understanding social determinants of health and (CHL-C) abilities that enable actions to the benefit of health and well-being in a collective (Chinn, 2011; Haugen, Riiser, Esser-Noethlichs, & Hatlevik, 2022). In this study we focus on the third domain of CHL, which revolves around social actions that adolescents can take to become active agents for health and well-being in a collective. The importance of cognitive and analytical skills for understanding and appraising health-related information is apparent in that most of the research on CHL in school contexts are being conducted within this domain (Haugen, Riiser, et al., 2022; Sykes & Wills, 2019). However, the ability of young people to act to the benefit of one’s own and others health and well-being are inevitably also dependent on social and democratic interaction abilities (Chinn, 2011). PE is an appropriate context for developing social interaction abilities (Ciotto & Gagnon, 2018), and  PE contexts are particularly well suited because they qualitatively differ from regular classroom settings by providing a more dynamic and interactive learning environment (McHugh, 1995). Importantly though, learning does not automatically occur as a result of participating in PA or sport within PE, but are dependent contextual and didactical considerations (Bailey et al., 2009).

In Norway PE is a school subject that is graded from 1-6 on equal terms as traditional academic subjects like Science and Language Arts. The grade reflects teachers’ assessment of several competences, attributes and skills described in national standards, including physical, social, and cognitive domains.

The main hypothesis for this study is that achievement in PE (as measured by expected grade) is associated with CHL-C. We also investigate how participation in sport club activities, leisure physical activity (PA) and parents’ education influences the association between PE and CHL-C.

This study is part of the Literacies for health and life skills project at Oslo Metropolitan University in Norway (Walseth, 2016). A cross-sectional digital survey was conducted in five partner schools during the autumn of 2021. In total 522 out of 1265 (41 %) pupils consented and responded to a digital survey during school hours. Those that did not bring a written consent or changed their mind about participation were given alternative assignments for the 10-30 minutes duration of the survey. CHL-C was measured with two scales from the CHLA questionnaire (Haugen, Esser- Nöethlichs, Riiser, & Hatlevik, 2022. Submitted for publication; Haugen, Riiser, et al., 2022). Both scales consist of three indicators measuring perceived abilities to support others (CHL-C1) and perceived abilities to participate in discussions regarding health and well-being (CHL-C2). Performance in PE was measured with one indicator asking pupils which grade (1-6) they expected to achieve in PE this semester. A confirmatory factor analysis (CFA) was conducted to examine the psychometric properties of the measurement models (the latent variables). Closeness of fit was evaluated with the unbiased Standardized Root Mean Residuals adjusted for average communality (uSRMR/¯R2 ≤ 0.5), along with a criterion of no individual residuals above 0.1 (Shi, Maydeu-Olivares, & DiStefano, 2018; Ximénez, Maydeu-Olivares, Shi, & Revuelta, 2022) Further analysis was conducted in four steps, with each step introducing a new parameter to the model being estimated. Step one introduces regression paths from PE to CHL-C1 and CHL-C2. In step two we add parents’ education as a predictor of PE and both CHL scales before we repeat the procedure in steps 3-4 with the variable’s participation in sport club activities and leisure physical activity. Global and local model fit will be evaluated for each step of the SEM analysis. We report recommended fit indices such as chi-square test (χ2mvadjusted) of exact fit (p ≥ 0.05), Comparative Fit Index (CFI ≥ 0.95), Root Mean Square Error of Approximation (RMSEA ≤ 0.05) and Standardized Root Mean Residuals (SRMR ≤ 0.05) (Kline, 2016).

Pre-liminary results Current analysis of the final model yields excellent model fit (χ2mvadjusted = 31.156 (df = 24, p < 0.149), CFI = 0.996, RMSEA = 0.024 [0.000, 0.045], SRMR = 0.036). In the model there was significant and positive effects from PE to both the dependent variables CHL-C1 (βPECHL-C1 = 0.264, p = 0.001) and CHL-C2 (βPECHL-C2 = 0.351, p < 0.000). Neither parents’ education, participation in sport club activities or leisure PA had a significant direct effect on the dependent variables, however they all had a significant and positive effect on PE, in total explaining 30.1 % of the variance in PE. Altogether the direct and indirect effects in the model explains 8.9 % and 13.1% of the variation in CHL-C1 and CHL-C2 respectively. The majority of this is the direct effect from PE, as can be derived by squaring the standardized regression coefficients (R2PECHL-C1 = 0.070, R2PECHL-C2 = 0.123). Conclusion This study contributes to the ongoing discussion on the role of health within the school subject of PE, and how PE contributes to health education in the Norwegian secondary school context. We hypothesized that achievement in PE could predict levels CHL-C among pupils in lower secondary schools. The result from our analysis supports this hypothesis as there is a significant association between PE and CHL. This association remains when control variables are added to the model. It is important to note that the cross-sectional design of the study does not allow us to make any conclusions about the causality of the associations. It is possible that higher levels of CHL is rewarded with better grades in PE. However, a reciprocal relationship seems most likely.

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