Health in physical education (PE) has in recent decades received growing public and political attention. PE is recognized as playing an important role in promoting health and well-being among children and adolescents.

From a biomedical perspective, researchers and stakeholders argue that PE should advocate a public health approach where physical activity (PA) is seen as a central means of avoiding lifestyle-related diseases and maintaining good health (i.e. McKenzie et al., 2016; Sallis et al., 2012). However, other researchers claim that the biomedical perspective reproduces a narrow understanding of health, which ignores how different environmental and social contexts impact people’s health (Harris et al., 2016; Kirk, 2018). When PE teachers uncritically accept and reproduce such approach, it can result in a simplified form of PE that primarily aims to promote PA participation for the improvement of physical health (Kirk, 2018; Maivorsdotter et al., 2010). Critical PE scholars contest the prevalent biomedical perspective on health for its narrow conceptualization of health and its exclusive focus on physical activity and disease prevention. Instead, holistic (critical and/or salutogenic) perspectives that emphasize the complex nature of health are advocated.

Holistic perspectives on health emphasize sociocultural aspects, strengthening factors, and resources that actively promote health in a relation between the individual and their surroundings (Kirk, 2018; Tinning, 2015). An additional line of research highlights aspects of sustainability where environmental, economic, and societal issues become part of holistic perspectives on health (Lundvall and Fröberg, 2022; Olive and Enright, 2021). According to Gray et al. (2015), it is important that stakeholders, teachers, and students regard health as a holistic concept encompassing social, emotional, psychological, and physical domains to deconstruct and challenge the current and prevalent narrow views of health. A salutogenic strengths-based approach can offer PE teachers a broader and more nuanced perspective on health, emphasizing how movement activities can enrich people’s lives (McCuaig and Quennerstedt, 2016; Quennerstedt, 2019). One limiting aspect, however, is that most articles concerning holistic perspectives have been theoretical and merely discussed the different perspectives on teaching health in PE. Little has been done to empirically explore and/or implement holistic perspectives in authentic PE settings (Mong and Standal, 2019). The prevailing narrow conceptualization of health and the dearth of empirical research with holistic perspectives on health highlight the need for more research and a broadening of perspectives. Hence, the overarching purpose of this study is to contribute to knowledge about what characterizes empirical research literature with holistic perspectives on health and discuss implications for teaching PE. Based on the aim, the research question is:

- In what ways do empirical papers with holistic perspectives on health address the teaching of health in elementary, secondary, and upper secondary school PE?

A scoping review was conducted to map the existing empirical research literature with holistic perspectives on health in PE and to identify and examine key characteristics related to the concept. The methodological framework from Arksey and O’Malley (2005) guided the process of developing, conducting, and reporting this scoping review. This process included: (i) identifying the research question; (ii) searching for relevant studies; (iii) selecting studies; (iv) charting the data; and (v) collating, summarizing; and reporting the results. Four databases were searched: SportDiscus, ERIC, Web of Science, and Scopus. The searches were limited to title, abstract and keywords, and peer-reviewed literature published in English language academic journals between 2002 and 2021. The following search string was used: “physical education” AND “health” AND “teaching” AND “education.” The selected search string was chosen to source appropriate papers, although we were aware of the risk of ending up with an extensive volume of data. The initial search was conducted in June 2021, and an updated search with the same search string and databases was conducted in January 2022. The 20-year period from 2002 to 2021 was chosen to present a contemporary picture of the field. When selecting studies, a PCC mnemonic was used to guide the development of inclusion criteria. The papers were required to involve: (i) PE teachers and/or students (population); (ii) teaching holistic perspectives on health (concept); and (iii) general education elementary, secondary, or upper secondary school PE (context). Furthermore, only empirical studies were included. The main reasons for exclusion of papers were: not teaching health in PE (e.g. content related to but not explicitly addressing teaching health); whole-of-school approaches; studies with a biomedical perspective on health; and not empirical studies. Exploring educational practices suggests a didactic framework for analysis. A rationale for didactical research is that education involves many different choices in terms of why, what, and how (Quennerstedt and Larsson, 2015). The analytical process was guided by how the selected papers addressed health as purpose (why), content (what), and form (by what/whom in terms of the resources used), and how this was described when embracing holistic perspectives on health. A thematic analysis was conducted for identifying, analyzing, and interpreting patterns, as suggested by Braun and Clarke (2019). Themes were abductively generated regarding the analytical questions.

The findings confirm that empirical papers with holistic perspectives on health, in the research corpus regarding teaching health in PE, are rare (n=12 out of 3263). Two themes were identified through an abductive analysis of the papers: (i) teachers’ philosophies and didactic considerations; and (ii) alternative ways to teach. The review manifests that although PE teachers may hold a narrow understanding of health and lack didactic competence to deliver relevant health-related PE, they are receptive to holistic perspectives and capable of critical reflection, if given the appropriate support and opportunities for professional development. Adopting holistic approaches to health in PE requires perceptive didactic considerations. Promoting students’ consciousness and agency to develop or maintain their physical, mental, social, and emotional health and well-being in and through PE is as much about the form and delivery as the content of teaching, where the educative aspects need to be highlighted. This requires challenging PE teachers’ understandings and beliefs and encouraging them to renegotiate their practice, by enacting critically conscious, inclusive, student-centered teaching approaches, contributing to students’ sustainable well-being. The included articles in our review show traces of elaborated didactic considerations and curricula design, but we recommend further research exploring alternative approaches and deliveries of holistic PE curricula. Another conclusion is that many of the arguments for holistic perspectives on health in PE align with the rationale for education for sustainable development (UNESCO, 2017), which could also suggest a reorientation for future PE. Lundvall and Fröberg (2022) have recently suggested how health in PE can be reframed when sustainable development issues become part of the holistic perspectives on health. The questions to ask are: what knowledge, skills, attitudes, and values will the students of today need to thrive and shape their world in an uncertain future, and how can PE contribute to this development?

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