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School principals are generally seen as key facilitators for the delivery and long-term implementation of activities on school health promotion, including health literacy. However, there is little evidence on the health literacy and health status of this occupational group. The purpose of this paper is to investigate the health literacy of school principals and its association with mental health indicators.

A cross-sectional online survey with German school principals and members of the management board (vice principals) was conducted (n = 680, 68.3% female). Demographic (gender, age) and work characteristics (type of school, professional role) as well as health literacy served as independent variables. Mental health as a dependent variable included well-being, emotional exhaustion and psychosomatic complaints. Next to uni- and bivariate analysis, a series of binary logistic regression models was performed.

Of the respondents, 29.2% showed a limited health literacy with significant differences to the disadvantage of male principals. With regard to mental health, respondents aged over 60 years and those from schools for children with special educational needs were less often affected by low well-being as well as frequent emotional exhaustion and psychosomatic complaints. Taking into account demographic and work characteristics, regression models revealed significant associations between a low level of health literacy and poor mental health across all indicators.

The cross-sectional nature of this study does not allow to draw conclusions about the causal pathways between health literacy and mental health. Although the sample has been weighted, the results cannot be generalized to the whole population of school principals. There is a need for evidence-based interventions aiming at promoting health literacy and mental health tailored to the needs of school principals.

This is the first study to investigate health literacy and its association with health indicators among school principals.

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.

The purpose of this paper is to introduce the HEPS project (Healthy Eating and Physical Activity in Schools) and discuss initial steps of the project implementation within EU countries. On the basis of the Health Promoting School approach as a conceptual foundation for the project, HEPS aimed at developing and implementing an effective tool for supporting the development of national policies on healthy eating and physical activity in schools across Europe. For this purpose, a package of publications (HEPS Toolkit) was produced and disseminated within the Schools for Health in Europe (SHE) network.

An initial implementation survey was carried out with national coordinators of the SHE network (n=24).

Results indicate that more than half of the respondents were familiar with and disseminated the HEPS Toolkit to relevant stakeholders at national, regional and local levels. However a number of problems and barriers in the implementation were encountered, such as lack of support and resources, existence of competing programmes, and frequent education and health reforms.

The findings are discussed against two models of implementation and a few recommendations are suggested for optimizing the further implementation of this, and other similar projects.

THE HEPS toolkit is the first attempt to support all EU member states in the development and implementation of a national policy on healthy eating and physical activity in schools. The involvement of the national coordinators of a well established European network of school health can be seen as an innovative way to implement and disseminate the project outcomes.