08.09.2015 Strengthening resources means establishing the skills needed to make healthier choices at an early stage

Health skills. The federal government is seeking to strengthen the resources available to the population by enabling people to learn health skills and to take responsibility for their own health. In line with the Federal Council's "Health 2020" strategy, the Federal Office of Public Health wants to increase equality of opportunity and improve the options available to the most vulnerable groups in society for achieving and maintaining good health.

Pictures Strengthening resources means establishing the skills needed to make healthier choices at an early stage


Pictures Strengthening resources means establishing the skills needed to make healthier choices at an early stage


How do health skills and personal responsibility develop in the individual? The Swiss bildung + gesundheit (b + g, education and health) network is a good example. b + g is a national network involved in implementing prevention and health promotion in schools and in promoting collaboration and coordination between the various stakeholders. The question of how health skills should be defined was raised at b + g (www.bildungundgesundheit.ch) as long ago as 2007. The network set up a working group to look at the question, and some lively discussion ensued. The members of the working group came from very different professional backgrounds (ranging from accident prevention to teacher training) and from different linguistic and cultural regions of Switzerland. The question that generated the most discussion was whether the health skills of a person are limited to his or her own health or whether they extend to the health of other people too.  

Definition of health skills

In 2008, the entire bildung + gesundheit network offered the following answer to the question: "Health skills mean the ability to turn knowledge about maintaining and restoring physical, mental and social wellbeing into personal and collective decisions and actions that have a positive impact on one's own health, on the health of others, on living conditions and on one's environment." It is a short yet complex text that over the years has helped us to give direction to our work. The text makes no claims to being applicable outside the network. It appears on the network's website as an illustration of the principles on which the network's activities are based.

The goal is to turn knowledge into actions, to make health more than just the absence of illness and to ensure there is a close connection between one's own health and the health of others, between personal health and one's environment.

In recent years, education experts in Switzerland have had to consider ways of establishing and communicating skills in general and health skills in particular as part of their task of developing curricula for the different linguistic regions.  

Skill means blending knowledge with ability

One aspect of health skills has been very present in teaching, education and training in recent years. The curricula for the linguistic regions (Plan d’études romand – PER for the French-speaking part of the country and Lehrplan 21 – LP21 for the German-speaking part) are skills-oriented.

As such, they take a correspondingly in-depth approach to developing skills. "By describing learning objectives in the form of skills, cultural content is bound to the subject-specific and generic skills and abilities that need to be acquired; in this way knowledge and ability, subject-specific and personal, social and methodological skills are linked with each other" (Lehrplan 21, Principles, page 5).

PER also makes a distinction between subject-specific and transverse (generic in LP21) skills. They are divided up slightly differently, but they are the same skills adapted to the different cultures in our linguistic regions.

It is extremely difficult to explain skills as an abstract concept, and it is therefore more useful to give an example of a generic skill: self-reflection (knowing and using one's own resources). This skill appears under "personal skills" in LP21 and under the transverse skill "collaboration" in PER.  

Pupils ...

– are able to perceive their own feelings and express them in a manner appropriate to the situation.

– are able to perceive and formulate their interests and needs.

– are able to assess the weaknesses and strengths of their learning and social behaviour.

– are able to draw on their strengths and make specific use of them.

– are able to analyse mistakes and consider alternative solutions. – are able to reflect on learning pathways, describe them and evaluate them.

– are able to compare their own assessments and evaluations with those from external sources and draw conclusions (evaluation by self and others).

– are able to implement the conclusions drawn from self-evaluation and the evaluation of others.  

Particular emphasis has been placed on self-reflection here because it is the first of the generic skills described in LP21. But the others are equally interesting and demanding.

Pupils work on the generic skills throughout their time at school, and for some skills, school can do no more than create a foundation. We all become more familiar with our resources and how best to use them after we have left school.  

Ability to make decisions with a positive impact on health

If health is more than the absence of illness, we cannot achieve it by drawing up long lists of diseases and risk factors. It is the integration of subject-specific skills with personal, social and methodological skills that will later put individuals in a position, for example, to combine the question of how much physical activity they need every day with the skill "is able to deploy strategies to complete a task even in the face of resistance and obstacles" (from LP21, generic skills, personal skills, independence, page 14) and to turn the result into actions that have a positive impact on their health.

Dominique Högger, Head of the Health Education and Prevention Counselling Service at the University of Applied Sciences and Arts Northwestern Switzerland (FHNW), has carried out a very interesting analysis of the Lehrplan 21 curriculum (www.fhnw.ch/ph/iwb/beratung/gesundheit/publikationen). He has identified some 700 references to skills in Lehrplan 21 that are connected with prevention and health education. Many of these formulations can be linked to several aspects. The self-reflection mentioned above is one of them, but consumption also features. Consumption in the context of using consumer goods and changing consumer habits, but also in the context of nutrition, consumer goods as status symbols, handling money, advertising, the debt trap, new media (opportunities, risks, online, data protection, security, sedentary lifestyle, etc.)

The Ottawa Charter and the b + g definition of health skills both state that health is more than the absence of illness.  

Teams of education specialists have spent years developing school curricula for the linguistic regions; work is still ongoing in Ticino. They have included health and the acquisition of health skills in this work. They have integrated health with other subjects in the curriculum, they have made connections and highlighted interrelationships. The result of their efforts can be seen in the 700 references to health-related skills in LP21!  

"Skills-orientation makes health education visible"

The curricula for the linguistic regions create a basis for coordinating teaching resources, they play a role in the continuing development of teacher training and in-service training and of courses offered at teacher-training colleges. At the same time, though, they are also a major resource for all institutions and organisations that want to promote health in schools. The curricula help to develop and inform the work done by health educators.

If health educators want to be perceived by schools as a resource, they must align their work with the educational system. Dominique Högger writes that "skills-orientation makes health education visible" (Health Education and Prevention in Lehrplan 21, page 21). His work is also a valuable resource for health-promotion work. It helps to give this work a more specific direction, to strengthen the resources that children and adolescents can draw on as they make their way into the future.


Dagmar Costantini, Drugs Section, dagmar.costantini@bag.admin.ch

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