Conference Agenda

Much is written about the commercial determinants of tobacco, diet, alcohol use and gambling, including through WHO Europe, but nothing on physical activity. This abstract reports on field-defining work in the commercial determinants of physical activity, presenting an initial classification of the major themes across physical activity areas subject to commercial influences.

These themes developed were: [i] commercial influence on active environments, especially through car manufacturing, urban development, and fossil fuels; [ii] the promotion of small screen time; [iii] the commercial sponsorship of sport and physical activity, sometimes delivered as marketing to distract from companies’ unhealthy products (e.g., Coca-Cola, McDonalds); [iv] programs delivered by the fitness and wellness industries; [v] commercial actors using the ‘concept’ of physical activity / active lifestyles to promote products (active footwear, active leisure clothes); [vi] direct private sector funding of physical activity programs; and [vii] commercial influences on physical activity researcher and scientific evidence.

These areas are mapped against the themes developed in the 2023 Lancet series on commercial determinants of health, but focusing on physical activity; these include political practices, distractor marketing and sportswashing, financial practices, influences on science and publication, and reputational actions by the commercial sector. These exist within the complex intersectoral nature and social determinants of physical activity, as physical activity is not one product or service.

This framework inform global practice and policy, in conceptualising commercial influences as part of the social determinants of physical activity and initiate public health actions to understand and counter these commercial forces.

The Healthy Lifestyles for Europe (HL4EU) project is a 30-month Erasmus+ initiative (January 2024–June 2026) aimed at strengthening cross-sector collaboration to promote healthy lifestyles through physical activity. The project responds to the growing burden of NCDs and health inequalities, while addressing the structural fragmentation that often characterises health promotion efforts. Physical activity promotion spans multiple policy domains such as health, sport, mobility, education, and urban planning, yet governance and responsibilities remain dispersed. This fragmentation limits coordinated action between sectors and across EU and national levels, reducing the overall effectiveness of health promotion strategies.

HL4EU brings together European and national organisations representing the fitness, physical activity, outdoor, health (healthcare professionals, patients, and caregivers), and active mobility sectors. The consortium aims to foster structured collaboration capable of creating systemic impact. Through dialogue, alignment of priorities, and shared ownership, the project seeks to strengthen cross-sector collaboration in European policy and practice.

The project combines research, stakeholder engagement, and policy development. A Call to Action established a common direction for collaboration. Good practices were mapped through desk research and stakeholder outreach, identifying 136 initiatives. These were analysed quantitatively to assess collaboration patterns, sector partnerships, geographic distribution, target populations, and innovation types. In parallel, virtual focus groups with 30 stakeholders explored key enablers, barriers, and implementation challenges. These insights informed a set of policy recommendations to support future EU action.

HL4EU also developed a good practice platform showcasing selected good practices and enabling knowledge exchange among organisations working on healthy lifestyle promotion across Europe.

Background and Aim: Place-based partnerships are increasingly responsible for co-ordinating action to increase physical activity and reduce health inequalities. However, regional decision-making is often constrained by fragmented and inaccessible evidence. In Wales (UK), five Regional Sport Partnerships lead local physical activity and health promoting strategies. This project aimed to develop “State of the Region” reports for two Sport Partnerships, synthesising data on physical activity, health and sport to provide accessible regional intelligence to support policy and strategic planning. Methods: Two Sport Partnerships in Wales commissioned the Welsh Institute of Physical Activity, Health and Sport (WIPAHS) to undertake a regional data review. Development involved two phases: i) a stakeholder survey exploring access to and use of data; and ii) collation, analysis and visualisation of multiple datasets relating to physical activity, health and demographic inequalities, producing region-specific indicators, trend summaries and accessible data visualisations. Results: Stakeholders reported strong interest in using data but limited confidence in locating and interpreting datasets, with many requesting training and clearer access to regional insights. This led to the development of a series of training workshops. A key barrier was the lack of alignment between existing surveillance: datasets use inconsistent terminology and definitions (e.g, physical activity, exercise, fitness), limiting the ability to combine evidence and generate comparisons. Conclusions: Regional data synthesis can strengthen evidence-informed policy and strategic planning for physical activity. However, improving surveillance alignment and strengthening regional capacity to access and interpret data are critical for enabling partnerships to translate evidence into effective policy and practice.

Purpose: In 2023 the Dutch Government launched the Action Plan on physical activity(PA) to encourage governments, community organisations and municipalities to carry out actions to stimulate PA from a systems approach.

Methods: The National Institute for Public Health and the Environment (RIVM) conducted a system evaluation study by running surveys among policy makers and organisations and by applying the action-scale model.

Results. Several positive changes were observed in the first two and a half years, but more could be have been achieved. For example, several Ministries have devoted more attention to PA. However there was little new policy from Ministries to promote PA at school or in the workplace – places where people spend much of their time sitting. In addition, an increasing number of organisations (up to 585) joined the PA Network Alliance. This resulted in new collaborations that help people be more physically active. However, mainly ‘simple’ actions, like sharing knowledge, which have limited impact on PA system change were performed. Finally, within municipalities, a growing number of domains are collaborating on the topic of PA.

Conclusions: To achieve the government’s ambitious target that 75% of Dutch people meet the PA guidelines by 2040, RIVM recommends that ongoing efforts using a systems approach are needed in the coming years. This will also require actions with more impact on the overall PA system such as changing societal beliefs related to PA. In addition, policymakers can do more to link PA to other topics, such as mental health and climate.

Globally, as well as in Sweden, children and adolescents are becoming increasingly sedentary, with many not reaching recommended levels of daily physical activity. Active school travel (AST), such as walking or cycling to school, provides an important opportunity to integrate physical activity into everyday routines. However, despite its potential health, environmental and social benefits, the prevalence of AST has declined and policy support remains limited.

To address this challenge, a collaborative initiative was undertaken in Sweden involving academia, national authorities, municipalities, and civil society organizations. Importantly, children—the end users—were actively involved in the process. The aim of this study was to explore prerequisites for active school travel and examine how children’s accounts of their everyday school journeys can inform policy development.

Using participatory qualitative approaches, children documented and reflected on their school travel experiences, highlighting barriers and opportunities for independent active mobility. Their perspectives were combined with cross-sector expertise and a child impact assessment grounded in the UN Convention on the Rights of the Child.

The findings informed the co-creation of a national recommendation for active school travel in Sweden. The recommendation encourages children to walk or cycle to school when feasible and safe, and calls on schools, municipalities and transport planners to create supportive environments for children’s independent mobility. The recommendation is now being implemented across Sweden through collaboration between national agencies, municipalities and other stakeholders.

By placing children’s perspectives at the centre of policy development, this work demonstrates how cross-sector collaboration can support healthier, more sustainable, and child-centred transport systems.

This paper examines the normative challenges posed by participation in high-risk sports within the framework of social (health) insurance systems. It draws on a recent amendment to the Slovenian compulsory health insurance legislation that sought to limit, or even exclude, coverage of health care costs arising from participation in “high-risk leisure activities”. Although the proposal was ultimately withdrawn, it triggered an important debate about the boundaries of solidarity and individual responsibility within publicly funded health insurance.

The contribution explores the underlying tension between the solidarity principle, which underpins compulsory health insurance, and the idea that individuals who voluntarily assume heightened risks should bear greater financial responsibility for the consequences. While social insurance traditionally operates on collective risk-sharing and universal coverage, the increasing prevalence of high-risk activities such as mountaineering, mountain or road biking, for example, challenges established assumptions about equal access to benefits irrespective of personal choices.

The analysis situates the Slovenian proposal within a broader constitutional and theoretical framework, addressing principles such as equality before the law, proportionality, private autonomy, and the social state principle. Particular attention is paid to the conceptual distinction between socially acceptable and socially excessive risk.

By critically assessing the withdrawn legislative initiative, the paper argues that restricting coverage raises complex constitutional and systemic concerns. Any attempt to recalibrate solidarity in compulsory health insurance must be carefully justified, proportionate, and consistent with the foundational commitment of social security systems to universality and equal treatment, as well as the idea of promoting, not limiting, personal freedoms.

Purpose:
Cardiovascular disease (CVD) remains a leading cause of mortality globally and in Canada. South Asian (SA) immigrant women experience disproportionately high CVD risk due to biological predispositions, reproductive health factors, and sociocultural constraints shaping lifestyle practices. Despite strong evidence supporting lifestyle-based prevention, culturally tailored interventions for this population remain limited. The Mediterranean lifestyle (MEDLIFE) has demonstrated cardioprotective benefits. However, its acceptability within immigrant cultural contexts requires further exploration. This study examines the acceptability of a culturally tailored MEDLIFE among SA immigrant women in Canada and explores how health beliefs influence adoption of health-enhancing behaviors.

Methods:
This qualitative study is part of a larger convergent mixed-methods doctoral project. Semi-structured interviews are conducted with SA immigrant women aged 18 years and older. The interview guide is informed by the Theoretical Framework of Acceptability and the Health Belief Model to explore perceptions of cardiovascular risk, beliefs about lifestyle modification, and perceived barriers and facilitators to adopting MEDLIFE components, including physical activity. Interviews are audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis.

Results:
The analysis identifies themes related to perceptions of cardiovascular risk, cultural understandings of healthy lifestyles, and the social contexts shaping engagement in health-enhancing behaviors. Findings highlight key facilitators and barriers influencing the integration of MEDLIFE practices in daily life.

Conclusions:

Understanding cultural and social influences on lifestyle adoption can inform the design of culturally responsive health promotion strategies that support sustainable engagement in health-enhancing physical activity and cardiovascular disease prevention.

Support / Funding Source:

Canada First Research Excellence Fund.

To respect the educational character of Physical Education (PE), it is necessary for students to assimilate theoretical content that supports the development of competencies related to health, motor skills, and an active lifestyle. This paper aimed to conduct a validation and standardization process of an assessment instrument designed to measure the level of theoretical knowledge among 6th-grade students in Romania, followed by an evaluation of students’ knowledge at this educational level. The study employed a standardized testing procedure, and participant selection was conducted using probabilistic sampling to ensure national representativeness (n=2352).

The validation and standardization process confirmed the instrument’s psychometric soundness, supporting its validity and demonstrating its feasibility for large-scale educational assessment. Using this validated instrument, the findings indicate that the average level of theoretical knowledge associated with PE reached the minimum passing threshold (grade 5 out of 10). Girls demonstrated slightly higher levels of theoretical knowledge compared to boys (t(2350)=3.32, p<.001, d=0.14), suggesting modest gender-related differences.

In conclusion, physically educated adults cannot be expected without the systematic development of theoretical knowledge during schooling. The validated and feasible instrument developed in this study provides a practical tool for monitoring students’ cognitive outcomes in PE and informing curriculum evaluation. Strengthening the theoretical dimension of PE may enhance awareness of physical activity benefits and support sustained engagement in active lifestyles. Moreover, the proposed methodological framework offers a transferable model adaptable to other educational systems.

Background and aim of the study:
The World Health Organization recommends at least 60 minutes of daily physical activity for children aged 5–17, yet around 80% of Hungarian school-aged youth do not meet this guideline. In addition, every fourth child is overweight or obese, and many students show deficiencies in physical fitness. The COVID-19 pandemic further worsened these trends. Schools are key settings for promoting healthy lifestyles, particularly in disadvantaged areas with limited access to sport opportunities. In response, the Hungarian School Sport Federation launched the Active School Program in 2022 to improve students’ health, fitness and health awareness by integrating regular physical activity into everyday school life through a whole-school approach.

Methods:
Schools voluntarily join a quality-management-based certification system supporting development in five areas: quality physical education, school sport, health-promoting environment, partnerships and communication, and student involvement. Implementation is supported by national coordination, regional coordinators, professional training and digital resources. Schools collect points by fulfilling around 80 criteria and may obtain bronze, silver or gold certification. Program impact is monitored through annual student questionnaires and the Hungarian National Student Fitness Test (NETFIT®).

Results and conclusions:
Participation increased from 75 schools in 2022/23 to 606 schools in 2025/26, reaching about 180,000 students. Early results indicate improving fitness trends and higher proportions of students meeting physical activity recommendations, suggesting that the program can effectively embed physical activity into school culture.