The recent spate of anti-transgender bills in the USA has created challenges for transgender and gender-diverse students’ health. While actions to promote conservatism over research-based guidance and ethical commitments to students are not new, the pace and vitriol of recent political changes is concerning. Even in states with strong civil rights protections for LGBTQIA+ people, the pace of anti-transgender legislation and policies being proposed and enacted has increased. In this context of rapid conservative backlash, it may be worth returning to equity-based strategies that focus on health concerns. While some scholars have argued that the political argument for gender-affirming policies, programmes and practices should move beyond health issues, health-based approaches may be tactically useful even if they may seem to imply a return to baseline arguments for respect and the value of diversity. This article begins with a short history of the complications arising when using research-based health information to counter socially conservative political tendencies. In contexts where conservatives have tried to make their personal values the values of their state, conservative policymakers and voters have ignored the rights of non-conservative families to have educational and political institutions also provide support their children. These policymakers have also neglected key findings from education and health research concerning gender-diverse youth. Within this context, health policymakers, professionals, practitioners and educators alike should work together to stand up and support youth.

Background: In the UK, infant mortality rates are highest among families living in the most socio-economically deprived neighbourhoods. The Midlands region is among the areas with the highest rates in the country. Key modifiable risk factors, such as teenage pregnancy, smoking during pregnancy and not breastfeeding contribute significantly to these statistics. Objectives: To develop artistically co-created animated videos, made by young people for their peers, that address four key health messages focused on reducing the risk of infant mortality and promoting healthier future families. Setting: The Midlands region of England. Method: Nine students were purposively selected from a school in a socio-economically disadvantaged neighbourhood in the Midlands. The students interviewed five artists and selected one of them to collaborate with. Together with the chosen artist, they co-created four animated videos conveying key health messages related to reducing infant mortality. This paper shares students’ reflections on their experience, particularly their role in developing new visual content for healthier futures. The artist’s reflections, along with team feedback and discussions, are also documented. Results: The process was embraced by young people as part of their formal education. Students felt valued, recognised the seriousness of the risks and were motivated to actively contribute to change. The co-creation of the artwork provided a meaningful and realistic context for their engagement. Access to support during message delivery, the importance of open communication and avoiding judgement or stigma were all identified as key issues to be addressed when undertaking future work of this kind. Conclusion: We describe how artists, researchers and young people in schools can collaborate to artistically co-create health care messages related to infant mortality.

Background: Condom education campaigns that aim to prevent early and unintended pregnancies can be undermined by local gender norms, religious edicts and ineffective sexuality education policies. In some schools in Ghana, both condom education and abstinence only education run concurrently. Methods: This study explored community attitudes towards condom education in a context of competing messages about sexuality education. The study adopted a qualitative case study approach involving three schools in the Komenda-Edina-Eguafo-Abrem Municipality of the Central Region of Ghana. Data were collected from in-depth interviews with pupils and educators. They were analysed by (1) template analysis and (2) using the Health Promoting Schools framework, which emphasises links between schools and communities in sexuality education programming. Findings: In the case study schools, condom education was implemented alongside abstinence education through partnerships between schools and the local community. Attitudes varied in the community – with some members rejecting condom education, while others encouraged their daughters into consensual relationships and contraception. The (Methodist) church locally also rejected condom education. The interplay between poverty and gender power relations puts young women at a disadvantage in decision-making about sex, including condom use. Simultaneously, cultural taboos and religious norms limit condom use and place 11- to 15-year-olds at risk of early and unintended pregnancy. Conclusion: Future policy must account for local gender norms, poverty and gender power relations, alongside prevailing religious beliefs that affect sexual health interventions. Unlike the current fragmented picture, a coherent sexuality education framework could effectively address these local factors, leading to better outcomes for sexuality and condom education programmes, with health and educational benefits for young people.

Objective: Pupils’ active involvement in the learning process may be pivotal for effective learning in food education and for connecting learned concepts to health-related behaviours. The objective of this study was to investigate effects of pupil participation on knowledge and satisfaction in the Norwegian school subject Food and Health. Design and setting: Thirteen classes from one lower secondary school in Western Norway were randomly assigned to two teaching intervention groups, with either moderate or high levels of pupil participation. The topic was seasonal fruit and vegetables. Questionnaires were responded to after 2 weeks and 6 months. Methods: Scores on pupils’ objective knowledge were calculated from multiple-choice and open-ended questions, and self-perceived knowledge and subject satisfaction were measured by Likert-type scale items. Difference between groups was determined using the Student’s t -test. Results: Multiple-choice scores did not differ between groups, but open-ended question scores were significantly higher in the high pupil participation group compared to the moderate pupil participation group at both 2 weeks and 6 months following the intervention ( p = .04). Pupils’ self-perceived knowledge was significantly higher in the high participation group compared to the moderate participation group after 2 weeks, as was pupils’ satisfaction with the lessons ( p < .001). Pupils in the high participation group were more confident that they could use what they had learned outside of school (2 weeks, p < .001) and make sustainable food choices (6 months, p = .02). Conclusion: Our findings indicate that level of pupil participation in food education lessons influenced pupils’ objective and self-perceived knowledge, and subject satisfaction. Further studies should investigate possible links to health-related behaviour.

Objective: Low mental well-being is increasingly reported among vocational education and training (VET) students. Changing moderate-to-vigorous physical activity (MVPA) and sedentary behaviour (SB) may be beneficial for student mental well-being (SMW). Therefore, the effect of an existing physical activity (PA)-based lifestyle intervention on MVPA, SB and consequently the SMW of VET students was investigated. Design: Quasi-experimental study Setting: VET schools in the Netherlands. Method: A total of 126 VET students participated in either education with an integrated 20-week PA-based lifestyle intervention or in a control group that received education without an integrated lifestyle intervention. PA and SMW were measured at baseline and after 20 weeks. The International Physical Activity Questionnaire was used to assess SB and MVPA. The Centre for Epidemiologic Studies Depression scale and Rosenberg self-esteem scale were used to assess depressive symptoms and self-esteem. Results: Repeated measures analysis of variance (ANOVA) revealed a significant time*group effect ( F (1, 93) = 7.53, p = .007, η 2 = .08) for SB: SB decreased in the experimental group compared to the control group. MVPA did not change over time in both groups. No effect of the intervention on self-esteem or depressive symptoms was found. Conclusion: The intervention was successful in decreasing SB. However, the intervention did not seem to increase MVPA, and the decrease in SB did not seem to influence self-esteem and depressive symptoms, future research should investigate whether a more intensive PA-based lifestyle intervention is more effective in increasing MVPA and SMW.

Purpose: This discussion paper critically examines the underlying assumptions of a range of conventional health education theories. It proposes a fundamental shift towards a self-directed learning (SDL) approach that reconceptualises health education as autonomy development rather than behaviour modification. Methods: We conducted a comparative analysis of six influential health behaviour theories, including the Health Belief Model, the Transtheoretical Model, Social Cognitive Theory, the Theory of Planned Behaviour, the Theory of Reasoned Action and the Information-Motivation-Behavioural-Skills Model. We examined their key components, core assumptions and prescribed educator roles. We then mapped SDL principles onto the World Health Organization’s (WHO) seven core health educator responsibilities to operationalise these as an alternative paradigm. Findings: In today’s digital landscape where health information is abundant yet of varying quality, conventional health education theories are limited in addressing contemporary needs. This paper examines how professional health educators can facilitate comprehensive autonomy development through SDL approaches. The SDL framework encompasses not only critical thinking skills but also the full cycle of autonomous learning processes, including self-assessment, goal-setting, planning, implementation, monitoring, reflection and adaptive problem-solving. This systematic approach to developing learner autonomy through professional health education practice fills an important gap in the literature and aims to develop individuals capable of independently navigating complex health landscapes throughout their lifespans. Conclusions: The SDL approach transforms health education from behaviour change to autonomy development, requiring health educators to shift from being authoritative experts to learning facilitators. This transformation suggests new directions for professional training, educational materials, evaluation strategies, and interdisciplinary collaboration.

Objective: Extending previous research on sleep quality and college students’ mental health, this study tested behavioural and cognitive precedents to sleep quality to inform future health interventions and programmes. Design: Cross-sectional surveys. Setting: The study took place in a large US Midwestern university. Method: Data were collected from two cross-sectional online surveys of college students to test the predictive utility of the theory of planned behaviour and the health belief model regarding sleep quality. The relationship between these cognitive predictors and the reported use of popular at-home sleep hygiene behaviours were additionally tested for their relationship to sleep quality and mental health variables. Results: Crucially, none of the tested popular behavioural remedies were linked to college students’ approved sleep or better mental health across both studies. However, when testing the role of cognitive factors on sleep quality, the health belief model was partially validated, and the theory of planned behaviour was fully validated. Increased perceptions of susceptibility and barriers and decreased self-efficacy were associated with worse sleep quality, which were in turn associated with stronger depression and anxiety symptoms and decreased well-being. In addition, positive attitudes, norms, and behaviour control were all indirectly related to college students’ better sleep quality and mental health. Conclusion: Cumulatively, these studies support the need to highlight cognitive factors when promoting sleep-related behaviours and provide example ways to do so.

Background: Far-right movements in the USA have increasingly opposed inclusive health education by deploying arguments that delegitimize LGBTQIA+ identities. These arguments often conflate ontological and epistemological claims, positioning gender and sexuality diversity as ideological rather than legitimate aspects of human experience. Objective: This article critically examines the ontological assumptions underlying far-right arguments against sexual and gender diversity in health education. It aims to expose the epistemic fallacies in these arguments and to provide health educators with philosophical tools to resist them. Methods: Drawing on critical theory and philosophical analysis, the author dissects far-right discourses, focusing on the rhetorical use of concepts like “gender ideology.” They employ Roy Bhaskar’s concept of epistemic fallacy to differentiate between ontology (the nature of being) and epistemology (ways of knowing). Results: The analysis reveals that far-right arguments rely on a conflation of epistemology and ontology to invalidate LGBTQIA+ identities. These arguments often rest on Christian theological assumptions disguised as objective science, weaponsising bodily materiality to maintain heteronormative power structures. Conclusion: Health educators should recognise the difference between epistemological and ontological claims and resist far-right rhetorical tactics. Acknowledging that health education primarily concerns epistemological work, educators can foster inclusive and safe learning environments while navigating conflicts of belief and values.

Objective: Across the USA, state-level Bills have been introduced that curtail discussion about gender, sexuality, and biology in public schools. Specifically, two Bills have recently been passed in the states of Florida and Texas that we engage with here as we think through the following questions: what ideologies related to bodies and sexuality are these Bills perpetuating; what implications does the codification of these ideologies have for health education, teachers and students; what are some possible long-term considerations and/or effects of these ideologies for the lives and bodies of the children being (un)educated under them; and how do these Bills contribute to students’ exposure to unwanted genital experience[s]? Design: This conceptual article uses past narrative inquiry data to explore the potential ramifications of these Bills. Setting: Eight women from the Midsouthern USA participated in the study. Methods: Data were collected through semi-structured, in-person interviews. Findings: Two understandings are explored in this article are (a) children must be protected from ‘inappropriate’ topics; and (b) sex before heterosexual marriage is wrong and dangerous. In doing so, we draw on literature that connects cultural and religious framings of sexuality and gender roles to the embodied and sexual experiences of women similarly to the ways these connections are inscribed in the laws. Against this as backdrop, we examine how adult women in the present have been affected by living under and/or with the norms and behaviours demanded by these Bills, and their cultural prescriptions and enactments. Conclusion: To begin the process of helping women unpack and free themselves from their accumulated genital baggage, we offer support for sexual literacy that encourages genital intelligence coupled with an open curiosity about other people’s bodies, experiences, and desires.

Objective: Cooperative housing has been linked to enhanced well-being, with growing interest in the grant-of-use (GOU) model, which emphasises collective ownership, shared daily life and the joint management of care. However, the specific benefits of GOU housing for older women remain underexplored. This study examines the relationship between older women’s involvement in GOU cooperative housing projects in Spain and their subjective well-being. Methods: This qualitative study explored the experiences of 10 older women involved in three GOU cooperative housing projects – two senior cooperatives and one intergenerational – in Madrid and Barcelona. Data were collected through two focus groups and two communicative daily life stories, with participants engaged in the cooperatives for periods ranging from 6 months to 10 years. The study focused on perceived benefits and barriers related to subjective well-being. Three core categories guided the analysis – community living, sovereignty in ageing and gendered ageism – along with two analytical dimensions – the transformative and the exclusionary. Results: Participants associated community living, greater autonomy in ageing, and reduced gendered ageism in their cooperative projects with improved well-being. They also highlighted challenges within GOU cooperative housing, including limited economic accessibility, governance difficulties and insufficient institutional support. Conclusions: Our study offers valuable insights for both theory and practice. Theoretically, it reinforces existing research on the health benefits of cooperative housing while addressing a key knowledge gap by integrating gender and age perspectives. Practically, it highlights the model’s potential and challenges, providing guidance for communities, professionals and policymakers striving for more inclusive and equitable ageing models.