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A key prerequisite for successful change in organizations is to understand and develop the readiness for change of employees and of their organization. In order to appropriately manage occupational and organizational health interventions, this paper aims to develop a health‐specific survey‐based measure assessing individual‐ and organizational‐level health‐oriented readiness for change.

A comprehensive longitudinal stress management intervention study in nine medium and large enterprises in Switzerland (n=3,703) formed the basis for subsequent validity and reliability analyses of the individual and organizational health‐oriented readiness for change measure.

The results show that health‐oriented readiness for change is a valid instrument for assessing the two subcomponents of current behavior and change commitment, both for the individual and organization as agents of change.

The change‐specific health‐oriented aspect, including the individual and the organization as agents of change seems to be plausible for a comprehensive assessment of employees’ readiness for change in health‐promoting change initiatives in organizations.

The aim of this paper is to identify the role of the principal in establishing a whole school approach for health and wellbeing. Two questions are asked: (1) What do successful Swedish principals do when they take on a whole school approach? (2) How do these results relate to previous research on successful school leadership?

This paper focuses on the complexity of organisational processes and considers the role of successful leadership in managing a whole school approach to health promotion. It presents findings from two different but interlinked projects, and draws on document studies and interviews with principals, student health team members and teachers in Sweden.

This paper argues that successful school leaders are crucial in establishing a whole school approach, because of the work they do to synchronise the health-promoting activities in schools. The study identifies four aspects of coordination that need to be enacted simultaneously when leading health-promoting processes. The fifth aspect identified is that a whole school approach is not limited to the school, but the whole local school context, i.e. a synchronisation between different system levels.

Although limited in scale, this paper reports key findings that could have practical implications for school leaders. The study suggests that successful school leadership research needs to use a health-promoting lens in order to make leadership practices health-promoting practices. It also proposes extended comparative research from different fields and contexts.

The health‐promoting school concept is a very promising framework which provides a comprehensive strategic approach to school health. Evidence suggests it is cost‐effective and will enhance the achievement of both educational and health goals. However, many barriers exist currently which are inhibiting its widespread adoption. Such barriers are related to resources; political issues; environmental contexts; administrative support; trained and skilled teachers; lack of understanding of the value of school health and the concept of the health‐promoting school. Teachers are fundamental to the success of developing a health‐promoting school. Evidence shows that there are priorities which need to be addressed in this area before schools can develop comprehensive and effective school health initiatives. Key among these are increased collegiality between teachers; ongoing and focused professional development; and embracing and implementing change within schools.

Achieving organisational learning and greater specificity for implementation action for health‐promoting schools requires detailed understanding of the necessary components. They include: preparing and planning for school development, policy and institutional anchoring, professional development and learning, leadership and management practices, relational and organisational context, student participation, partnerships and networking, and sustainability. This paper seeks to elaborate a theoretically based rationale for how these eight components of implementation that needs to be put into action.

Building on the narrative synthesis in the complementary paper (“Theoretical base for implementation components of health‐promoting schools”, this issue), examples drawn from empirical research and evaluation reports in the field of health‐promoting schools are used to operationalise the function of the components.

This elaboration anchors specific implementation actions within their own theoretical and empirical base, a significant advance on previous guidelines. The eight components have been articulated separately. However, in practice they operate interdependently. Context and culture issues also need to be accommodated.

The level of specificity provided in this paper has the potential to enhance school staff professional learning, as it fulfils one of the characteristics for successful school‐based education, namely practical, detailed implementation and enough flexibility, allowing shaping to suit specific contexts.

The identification of this knowledge base should enable practitioners to develop an in‐depth understanding of the operational functioning of existing guidelines, thereby enhancing their practice. The specificity provided holds promise to enhance the science base and quality of implementation.

The purpose of this paper is to introduce the official statement of the Fifth European Conference on Health-Promoting Schools.

The Fifth European Conference on Health-Promoting Schools was held on 20–22 November 2019 in Moscow, Russian Federation, with over 450 participants from 40 countries. A writing group was established to prepare a draft version of the statement before the conference. On the basis of an online and offline feedback process, the opinions of the participants were collected during the conference and included in the finalisation of the statement.

The final conference statement comprises six thematic categories (values and principles; environment, climate and health; schools as part of the wider community; non-communicable diseases (NCDs); evidence base; and digital media), with a total of 23 recommendations and calls for action.

The recommendations and calls for action reflect current challenges for Health Promoting Schools in Europe. They are addressed to all actors in governmental, non-governmental and other organisations at international, national and regional levels involved in health promotion in schools and are to be applied for the further development of the concept.

This paper suggests that there are two different paradigms within health education and the health‐promoting school, the traditional/moralistic paradigm and the democratic paradigm. The Danish network of Health Promoting Schools favours the democratic paradigm, within which the overall aim is to develop students’ abilities to influence their own life and the society – their so‐called “action competence”. The nature of an “action” is defined here as being “purposefully directed at solving a problem or facilitating change and consciously decided upon by those carrying out the action”. The key factors which influence action are discussed: they are insight and knowledge; vision; commitment; experience; and social skills. The paper then looks more deeply at insight and knowledge, suggesting that it has four different dimensions: knowledge of effects; causes; the processes of change; and vision of future possibilities. It suggests that teachers themselves need both the educational competence to facilitate the education of others, and high levels of action‐oriented knowledge and insight.

Drawing upon self-determination theory, this study investigates the direct and indirect impact of health-promoting leadership on employee engagement via workplace relational civility and explores the moderating effect of employability on these factors.

The authors collected a total of 723 matched and valid responses from nurses in Guangxi, China. Data regarding health-promoting leadership, workplace relational civility, employability and employee engagement were gathered using a survey administered in two waves, 1 week apart. The authors utilised structural equation modelling and linear regression to test the model.

This study reveals that health-promoting leadership has both direct and indirect positive effects on nurses' engagement through workplace relational civility. Furthermore, the authors found that employability negatively moderates the impact of workplace relational civility on nurses' engagement but does not moderate the impact of health-promoting leadership on nurses' engagement.

This is one of the few studies that have examined the effects of health-promoting leadership within the nursing industry. The authors confirm the importance of health-promoting leadership and workplace relationship civility on employee engagement. In addition, this study demonstrates the moderating role of employability in employment relationships.

The purpose of this paper is to provide insight into teachers’ practice in implementing school-based health promotion.

This qualitative research was designed as a multiple case study. The study involved five schools, 233 pupils in the age 12-16 and 23 teachers. The primary data generation method were focus groups.

According to the national guidelines the health education in primary schools in Denmark should be based on the critical approach to health education developed within the European Network of Health Promoting Schools. However, the study showed that teachers’ implementation of the guidelines in practice was closer to traditional health education, which focuses only lifestyle change, than to critical health education which also explores the underlying conditions for health.

The study explored teachers’ implementation practices, and the individual and institutional factors that influence the practice. This paper restricts itself to examining teachers’ practice against the national curriculum guidelines.

The teachers were not sufficiently familiar with the curriculum guidelines or the critical approach to health education. The inclusion of the national curriculum and the principles of critical health education in the initial and in-service professional development of teachers is an urgent priority if this gap is to be reduced.

This paper contributes to the debate related to the potentials and barriers for implementing of health promotion interventions in a school context.

With the aim of contributing to the evidence base on school‐based health promotion, the authors discuss the outcomes and processes of a European intervention project aiming to prevent obesity among children (4‐16 years) and promote their health and well‐being, titled Shape Up: a school‐community approach to influencing determinants of healthy and balanced growing up.

Multiple case study research was carried out in five schools in five EU countries. Data sources included project documents, interviews, and observations. Narrative qualitative cross‐case analysis was carried out following the single case analyses.

The study showed that, if given sufficient guidance, pupils can act as agents of health‐promoting changes on both school and local community level; they were involved in actions which improved school policies, provisions and affordances for healthier diet and regular physical activity. The study identified three forms of participation, each with a different level of pupil involvement and agency.

The study is qualitative, based on five single cases and cross‐case analysis; this research design implies caution related to extensive non‐contextualised generalisation of the findings. However, valuable implications for research and practice can be drawn, especially in relation to structural barriers for participatory health promotion.

The paper is of value for researchers as well as practitioners in the field, particularly those interested in eco‐social models of health, whole‐school approaches to health promotion and pupil participation. The study's specific value is in the systematic qualitative cross‐case analysis, which contributes to the research rigour and allows for situated generalisation.

Workplace health promotion (WHP) is becoming increasingly important due to the ageing workforce and a shortage of skilled workers. Nevertheless, too few companies have reacted to the demographic change and introduced health-promoting measures. This paper aims to identify which factors influence the implementation of WHP, especially in small and medium-sized enterprises (SMEs) in rural areas.

253 companies in a rural area in the federal state of Saxony (Germany) were surveyed using a standardised questionnaire via a computer-assisted telephone interview. Bivariate analyses and logistic regression models were carried out. The focus was on the relationship between the status of WHP and the size of the company, pressure of demographic change, health-related attitude and organisational capacity factors.

It was shown that, in addition to the control variables company size and pressure of the shortage of skilled workers, a company's attitude regarding health promotion, financial capacity and planning and development capacity has a relevant influence on the status of WHP.

Based on the results, targeted measures can be developed and converted to implement WHP, particularly in SMEs in rural regions. The focus should be on sensitisation, knowledge transfer and capacity development.

The present paper reveals the relationship between company size, pressure of demographic change, health-related attitude and organisational capacities regarding the status of health-promoting measures in SMEs in a rural region.