 I started working in research and therefore looking at health literacy and schools, looking at health literacy of students, of teachers, of school principals and in the whole school setting is something I really, really think is important and I'm really passionate about. And therefore on my first slide I just want to begin right away to show why I believe based on the evidence that we gathered, health literacy is so important to schools. So we did for the Schools for Health in Europe Network Foundation. I'm sure that many of you know this network, the SHE Network. We did a report and an evidence synthesis and collected studies that have been conducted on health literacy in the school setting. And based on that evidence, we developed a model which I will be introducing now that shows that health literacy of students is associated, so the higher the health literacy is associated with positive health related attitudes and behavior. So when the health literacy is higher, health behavioral outcomes are also better than in children in adolescence in students with lower levels of health literacy. And we also could see based on these studies that health related attitudes and behavior directly have an effect on the health status, the health condition of children and adolescents. And if we follow that chain, we can see that the health status of the school students is directly related to school and educational outcomes, both on the short and midterm and long term. So you see that there is an indirect relationship between health literacy through behavior through health status on education, which is what makes health literacy so important to schools because healthy children learn better, healthy children get better health outcomes, and schools are more likely to accomplish their goals to provide education. And in this sense, we can say that health literacy is a determinant of health behavior. And what we also know is that education is a determinant based on all the studies that are available out there for the past 40 to 50 years, a determinant of all things that are related to health. So you see why health literacy is affecting education or health is affecting education. Education has also an effect on health. Based on the studies that led to these models, we could also see that it is not only about the behavioral or the competence or the literacy components that are so important in this chain, because every child comes from a home and every home is different. We have to account for the differences in the children's home and the socioeconomic background. So there is a different family effluent, different cultural background with different cultural capital that is available or different educational and social capital that is available, for example, in the parents and also the state of development. So these are preconditions, so-called structural, environmental, or context related factors that have an impact on health literacy. And as I just shown you, health literacy then has an effect on different health outcomes, which was worse, have then an impact on education. So this is the evidence based from around 2020. And in the past years, a lot of new projects have started here at my working group, but also in the working groups of many other colleagues around the world. So probably in the next years, we will be adding new evidence to this model. And now I want to show you, based on the literature that you can see on the right-hand side, why health literacy in particular in children and adolescents and in context of school is so important, because lower levels of health literacy in children and adolescents are associated with a series of adverse health outcomes. For example, children with lower health literacy have also less health knowledge. They more often practice unhealthy behaviors, such as smoking, alcohol conception. They do less physical activity, et cetera, et cetera. They also have more problems with health communication or in handling and managing health information. They have a problematic or a more problematic social media use compared to children with higher levels of health literacy and also problems in critical health thinking. Poor academic performance, poor self-esteem, and of course, very importantly, poor physical and mental health outcomes. So altogether, this already makes health literacy a very important topic to be addressed as early as in childhood and as early as in schools. But on top comes that lower levels of health literacy are also associated with a lower socioeconomic background, meaning that we have a social gradient in low health literacy, making health literacy an important health target, an important intervention target, an important school target in context of health equity and health inequalities. So promoting health literacy will also help to overcome some barrier, some shortcomings related to health equity. So you see, these are some of the important facts, why it is so important to address health literacy alongside other school subjects, alongside other school topics in context of health promotion and health prevention in the school setting. And in 2021, we have worked together with the WHO Regional Office for the Child and Adolescence Public Health Department on a report on health literacy in the school setting in context of well-being of children and adolescents. And of course, I cannot summarize the whole report. You can download it on the WHO website, but I have brought some important facts from the report. So first of all, of course, based on the issues that I just raised, health literacy has to be understood as a core public health issue when it comes to children and adolescents. And we believe that addressing health literacy is important and that schools as formal educational settings where you can strengthen educational, social, cultural, emotional and further competencies is so important to help children to acquire the necessary competencies that are needed in context of health, to empower them to share and promote skills for them to be able to make informed decisions about health and become agents of their own health. So these are some of the reasons why we believe that schools are so important. They reach all the children for a very long amount of time, making schools the ideal setting for interventions. No matter what kind of background children have, you can reach them all. And we have also in this report identified some core skills that we believe are very important in context of health literacy. For example, accessing and navigating health information environments, understanding health messages in particular in social media, false claims, fake news, commercial determinants of health, et cetera. Through health literacy, children will also be competent to think critically about health claims they encounter in their daily lives and they can also make informed decisions about health based on their health literacy. They can acquire new health knowledge and use that knowledge in new health situations so they can make a translation of what they learned to new life circumstances. They can also take part in communication about health, using health behavior, developing healthy practices and healthy behaviors and healthy attitudes. And they can also engage in healthy activities and avoid unnecessary health risk, which is very important. But they can also become aware of their own thinking and their behavior when it comes to health. They can, for example, also identify and assess bodily signals from feelings, from symptoms. They can act ethically and socially responsible towards themselves, towards others and towards the society. And from the educational perspective, the teacher, the school perspective, of course, it is very important. We just learned that healthy at school children have better health outcomes. Of course, true health literacy, then we can also address learning. The children become lifelong learners, self-directed learners and increase their educational outcomes, their educational achievement, their educational aspirations. And they can also develop a sense of citizenship based on the model of health literacy that you are looking at. And last but not least, we have already talked about health literacy in context of health inequalities. True health literacy based on the models that are available out there, children become competent in order to understand that there are factors outside the personal competences, outside their own behavior that have an impact on health literacy so that they can address and mitigate the effects of the social, the commercial, the digital, the ecological, the cultural and political determinants of health. So this is very important because maybe also probably one of the most important things that health literacy enables children to do to act on the determinants of health. So we can consider health literacy in the context, in the realm of health promotion and prevention as a determinants-based approach. And if you would ask me to summarize these many competences, these many components of health literacy, I would break it down to three main components that I believe that make up health literacy altogether. First is, health literacy is about the competent management and handling of health information. So dealing with health information is always in the focus of health literacy. Second is communication and interaction about health topics. So it's dealing about health information and communicating about health information. And last but not least and very important, through health literacy, information, knowledge, attitudes can be translated into practices, into behavior, into action. So it's about translating the acquired knowledge, the gained skills to make informed decision and practice healthy behaviors. And so these three areas are the most important areas in context of health literacy. And I want to show you one definition that is being widely used. It has been developed in the context of public health, but it is based on an analysis and an evidence synthesis of many definitions out there and represents what all the other definitions have in common. And it describes health literacy as linked to literacy, so reading, writing, numeracy, et cetera, and that it entails people's knowledge, their motivational and competencies to access, understand, appraise and apply health information in order to make judgments and take decisions regarding different areas of health, such as health promotion, disease prevention, and health care. So this is a definition of health literacy, which very well represents how I, for example, would understand what health literacy is all about and how I would address health literacy in the school setting. From the health promotion perspective, there is also a different way of conceptualizing health literacy. Still based on the same definition that I have shown you, you can also distinguish health literacy into three different dimensions, functional, interactive, communicative, and critical health literacy. And as you can see at the bottom, we have the functional skills, the reading skills, the writing skills, understanding, mathematical, numeracy skills, et cetera. And in the interactive area, it's more about talking about health, interacting about health, communicating about health, taking part in social and community actions, et cetera. And on the highest level, it's all about appraising, evaluating, judging about health information, but also to understanding that there are determinants of health which can be addressed and modified in order for the health benefit of oneself or others. And all these different understandings, the models and definitions that I've just shown you seem to define health literacy as a behavioristic, a behavioristic approach. But on the contrary, health literacy is not only to be reduced on behavioralistic or competence related factors. In fact, health literacy has to be understood as a relational concept. And this is what this figure shows. On the left-hand side, where we have the behavioral level, the personal knowledge areas, the abilities and the competencies, this is where we would place personal health literacy, where the action level is on the agency level and it's all about behavior change of individuals. And this is also where the definition that I have just shown you is rooted. But as you can see, in health literacy, we have two sides of the same coin and both of them need to be addressed. On the right-hand side, you have the environmental level with the systemic demands and the complexities put upon people. And this is where we have to address the structures and the social change in contrast to agency and behavior change. This is also where we have a systems level, a systems approach, and the organizational health literacy. And you can see at the bottom a definition for organizational health literacy. And when you read it, you can see that it is complementary to the personal health literacy definition. And in fact, an organization that is health literate helps people to develop their full potential regarding their personal health literacy. But it also helps, and this is what you see on the right-hand side when it comes to interventions and measures to be implemented in a setting, to decrease the complexity and the demands of a system or of organizations or institutes or settings put upon people. We're in contrast on the left-hand side, when you look at the behavioral level, it's more about improving and enhancing personal capacities, competencies, and knowledge areas. And you can see that how these two areas need to come together. When you look at interventions or think about interventions, in particular, from a teacher perspective, in order to increase the personal level of health literacy, you can do it by targeted education programs, classroom action, whole of school action, et cetera, et cetera. Whereas on the right-hand side, when you aim at the organizational level, the environmental level, it's more about targeting the organization, the environment as a whole, the determinants of health, and also to reduce situational demands and optimize interaction in the setting and increase institutional support. And you have to understand this as a concept, as an approach health literacy that needs to be brought into balance, the balance between the behavioral and the environmental level. So you see, it is not only about a reductionist, an individualistic or a behavioral approach. It is a whole, when you look at school, whole school approach or a whole of systems approach to health literacy, which makes health literacy so important and so unique. And on this slide, I brought you a slide from my colleague, Lena Packery from the HBSC, the WHO Health Behavior in School-Age Children Study, this is a study which is being conducted in European countries on health and health behavior of children, and sometimes they also measure health literacy here. And you can see different European countries and the state of health literacy. And I don't want to dive into detail because these results also have informed our evidence and tests, but you can clearly see that there is a difference between the levels of health literacy between different countries while some such as Macedonia or Finland are doing rather well. When you look at the red or the light green area, other countries or most of the countries are not doing so good. For example, you can start Estonia, Slovakia, England, Germany, Austria, Czech Republic and Turkey where the proportion of school children with lower levels of health literacy is rather high and also only few children and adolescents really achieve to have very high levels of health literacy. So you see based on this figure, there is actually a lot to do when it comes to health literacy. These are children 15 and 17 years old, so older adolescents. But health literacy is also important in younger school students and we have conducted in different projects of our health literacy in childhood and adolescence research consortium, studies in primary schools on health literacy in fourth graders, eight, nine, 10 and 11 years old. And what you see here are the most recent results of a study that we wanted to conduct in 2020. But because of the corona pandemic and school closures, the pandemic impact on the whole educational settings, we couldn't finish the study. So we are at the moment as we are speaking, redoing that survey because now the situation has, I wouldn't say it has cleared, but it is much better. It's not that worse as it has been in the years 2020 and 2021 and earlier in 2022. So sometimes early next year, we will have finished the study and have a representative data set. But what you see here is the sample that we were able to collect in 2020. And we could survey 515 school children in a representative sample in primary schools in the state of North Rhine-Westphalia, which is one of 16 federal states. And you can see here a very similar result to that of the adolescence from the HBSC study while 76% of the children state that they find it easy or rather easy to deal and manage health information. You have a force, so 24% of the children stating that they find it rather difficult or very difficult to deal with information. So this result is a bit better than the result that we have seen in adolescence. And we can ask the question, is it that children that young are more competent, do no more, have really higher levels of health literacy or are there probably other reasons in place why children in that age group report because we are surveying health literacy using a self-report questionnaire, higher levels of health literacy than their adolescence counterparts. And there are different ways of approaching to explaining why we end up with such a good results of health literacy of young children. First of all, they are very young. Probably they underestimate the complexities of the healthcare sector or the complexities when it comes to health promotion. They maybe also lack the experience interacting in health matters, taking care of their own health. Probably it's mostly the parents that do everything related to health prevention, health promotion, healthcare when it comes to their children. And it could also be that they overestimate their own competencies when it comes to health literacy. So you see, there are different ways of trying to approach to explain why we have these results but compared to results that we have in adolescence where there are a bit more major, a bit more experience, we can see that there are much more different results that one can generate when it comes to health literacy of children and adolescents. But interestingly, we could see that health literacy of children in this study that we have conducted in the primary school is the strongest predictor for a series of health outcomes. For example, mental and well-being outcomes, physical health, subjective health status and also health behavior. So this is a finding that we could already see in the model that we have produced for schools for health in Europe. And this is a study that we have conducted later, later than we have developed the model and you can see we get really similar results on that. So despite the fact that health literacy, that the children report that they have not so many problems so much or are so big of problems and dealing with health information, you can see here some selected items with action areas where they state to have more difficulties when it comes to dealing with information than other items. For example, how to find out to recover quickly when they have a cold or understand when and how they should take a medicine when they are ill or judge what helps a lot to stay healthy and what does not help so much. So these are things where up to a third or even more than a third of the children state that these are particular tasks that they found are difficult to undertake. And since we are still in the midst of the corona pandemic, I think these results will be highly relevant because these are the first results ever to be generated in children on corona-specific health literacy. We did some studies with adults here in Germany, in Austria, in Switzerland and in the COVID Health Literacy Network. We have where we have more than 70 countries that are members of the networks have conducted a lot of studies in different settings, in different countries, on different dimensions of health literacy. They haven't been done so far in children, in particular not in children as young as in primary school age. And you can see here that we have a total different picture from the picture that we have seen on the general health literacy. So you see that they're corona-specific. They have much more problems in dealing with corona-specific health information compared to general health information. For example, almost half of the children find it very difficult to find information about the corona virus or understand what they read or hear about the corona virus. They also have problems in deciding which information on the corona virus is reliable and which not. And this in particular is so important in the age of the internet, digital realm, social media, commercial determinants that all have an impact on our children and on their understanding of health information and how they make informed decisions. So as I said, this study is being repeated as we speak under very different circumstances than we had in 2020 and 2021. And I hope that sometimes early next year we will finish the study and we'll be able to present a much broader data set, much broader evidence on health literacy of primary school children. But altogether these aspects made it clear make it clear for me and maybe also to many of you that in order to sustainably address health literacy on an early age, one of the very important life stages is when children reach the school age, when they enter the educational system, when they start attending school from first grade on. And there are different aspects that you can address and I will dive into them in detail later on. But first of all, I will show you why it is so important to address health literacy as early as possible in the life course. This is what this figure shows when you address interventions in adulthood. The impact is rather small. So you cannot change much whereas when you address it early, the impact is much higher, especially when it comes to aspects that are related to cognitive, social, cultural, emotional developments such as competency development. So you have a far greater effect if you address health literacy early. In schools, I mean schools are already the main task of schools is to promote competencies, is to promote knowledge, attitudes, positive behaviors, educational attitudes and aspiration, et cetera. And they have the professional capacity, the teachers, the principals, the other pedagogical and non-pedagogical staff working in a school. Their main task is to exactly address children's development in terms of education. But also this is very relevant to health and also to the development, the early and sustainable development of health literacy. But, and there is always a but, challenges and barriers people encounter. Maybe you will also encounter them when trying to address health literacy in schools. And there are many, for example, health literacy is a rather new topic. Not everybody in the school context knows about health literacy or understands immediately what health literacy is or how health literacy is different from other concepts such as health skills or health knowledge or life skills or general skills or health behavior, et cetera. So you see, we have a new concept and we need to make clear that we try to explain to people in detail, very hands-on, probably also by using a very plain and hand-on language what health literacy is. On top cost comes that there is a mandatory curriculum in schools. There are a lot of educational policies but there are almost none for health literacy. So you will probably, when you look at the education systems in the world, one, two or three educational curricula, educational policies supporting health literacy in schools. And in many countries, in my country, in Germany, and it is the case, there is no mandatory health education. And health education is the subject which leads to health literacy. So health literacy is a learning outcome of health education. And in many countries, there is no health education in place in school which makes it much more difficult to address it. And then even if you would be able to bring health literacy to schools, the school curriculum is already overcrowded. So there are so many topics that are being addressed in school. It might be in many cases, it is in fact difficult to introduce new topics because there is no time to address these new topics in particular if they are not part of the curriculum because you will always, as a teacher, address that what is in the curriculum and mandatory to address. And I believe that many of you, many educational system will face these barriers, similar barriers and challenges. But there are ways and mechanisms how to overcome this. And one is, for example, to look in a certain country in the curriculum and try to see what kind of concepts, what kind of learning goals, competencies, educational frameworks are addressed. Maybe there is something in there that is related or linked or similar to health literacy. And when you remember what health literacy is, it's about finding, understanding, evaluating, using health information, making decisions, communication, critical syncing, et cetera, et cetera. So these kind of issues are very important to health literacy. And when you go to your curriculum and try to identify concepts that address them, maybe there is something that you can use to promote health literacy, something that is already in the mandatory curriculum. For example, in Germany, we have screened the curriculum in one of our projects, Tool Health Literacy. And we could identify the curriculum on digital education. And this is what you see here. It has six competence areas, six dimensions. And when you have a closer look, this is a mandatory curriculum, right? So on the federal level, it is called digital literacy, the mandatory curriculum on digital literacy. And since we are a federal state with 16 federal states, and education is the responsibility of the state. So it is not the federal government who tells the states what to address in education, but the responsibility of the state government. And on the state level, this digital literacy curriculum is being translated with the term media literacy. So just for you to know, digital literacy and media literacy in this context are used interchangeably. And when you have a closer look to this curriculum, you will clearly see that in the three areas where I have put the arrows to, clearly health literacy can be addressed. Yeah, you see information and seeking skills are there, communication is there, presentations or kind of interaction is there, analyzing, reflecting, evaluating is there. And digital literacy doesn't come or media literacy doesn't necessarily come with a topic. When you have to address it in the classroom, you can decide yourself, what kind of topic do you want to use for this? And in the case you decide to use something like this and use health as a topic and address these dimensions, then you will become able to address health literacy. And the good thing about school curricula is always that they are comprehensive. So they are addressing much more things that are very important. For example, here you can see use and operate media. You can address health literacy in context of media, address using hardware, what are devices, digital tools to organize yourself in digital context, but also about important things like as data protection and security, which become very, very important in the age of the internet and social media. And so is on the right-hand side, information and technology, the area of problem solving and modeling where it's a lot about algorithms, understanding that for example, when they access social media platforms, such as Twitter, YouTube or all the other platforms, that in the background there are certain algorithms that are responsible to bringing some messages up, probably also attached with commercial interests, et cetera, all based on some sort of algorithms that we often don't see, but they are there and they have their effects. So you can see these kinds of model and I'm sure that in many of the European countries, there are similar curricula available that you can use to address health literacy. So based on this curriculum, we have developed the toolbox health literacy, which is a classroom manual to strengthen health literacy. It has different dimensions. For example, it addresses different health behaviors, but also how children can deal with social media, health information, fake news, conspiracy theories with COVID-19, et cetera, et cetera. And always the focus is on health information. And the good thing about this information, by the way, it is open access and you can just download it on our website. It's in German, but you can, for example, use Google translator or deep L to translate it. And if you're interested, you can also translate the whole curriculum. And the good thing about these kind of approaches, when you look at the challenges, it directly responds to these challenges. For example, it is new to schools, but this is kind of helping to introduce it. It is, there is no mandatory curriculum, but here we can see it is integrated into an existing mandatory curriculum. So it links a topic, it links health literacy to a topic that is in the curriculum. So it is not an extra topic, you don't need extra time because digital literacy or media literacy is something you have to address anyway. This curriculum starts with grade one and goes in Germany through grade 13. In some other European countries, school ends after 10 years or after 12 years here, you can use it for 13 years. So it is a very long period where you can make sure to address different contents based on the cognitive development of the children. Not the early promotion. It has also components for teacher training. So when teachers familiarize themselves, they get the necessary teaching skills, the necessary health literacy skills to become competent to address health literacy and the classroom. And of course, I believe when I look at the curricula of many other education systems in the European region, I can see that similar curricula are available in these countries as well. And so they could easily be used to address health literacy. So probably in context of information literacy, media literacy, classroom literacy on the classroom, digital literacy on the classroom level for teacher education, or to address a phenomenon like commercial determinants of health or the infodemic, which has impacted us in the past couple of years, information epidemic, which came along with the COVID pandemic. And you can see the only thing one needs to do is to use these approaches, information media and digital literacy and use health as a topic just to make sure that what you do is health literacy. So, and I've talked a lot about the COVID pandemic and I want to give you a practical example if you wish as case study or case example, what children in context of COVID-19 can do with health literacy. And here's a very brief list. I've narrowed it down to the most relevant things. For example, through health literacy, they can acquire and use knowledge about the coronavirus. And we have just seen from our survey that there is a need on the children's side to exactly do that. They can understand health information and apply the behavioral recommendations for hygiene, hand washing, physical distancing, social distancing, face masking, getting vaccinated or getting tested. So it's very important for them also to participate in risk and health communication, right? On the interactive and communicative levels of health literacy, but they can also use health literacy to access different online sources for health information and evaluate online health information and sources. They can critically judge about information and sources, recognize this and misinformation, engage in fact checking on the internet or social media and therefore they become aware of the infodemic and competent to navigate the infodemic or the commercial determinants of health, right? So you see, there is a practical value in the context of COVID-19 to address health literacy so far that you can say that health literacy is a social vaccine, right? It doesn't act on the biomedical vaccine level, of course, but when you take a social level, mobilization, health policies, health promotion action, community empowerment, et cetera, et cetera, this is when health literacy can used as a social vaccine. So this would be like COVID specific or COVID related health literacy. You can also look on health literacy in the schools from a mental health perspective. And in one of our other projects, we have in the Impress project, which is about mental health literacy in the schools, we have adapted a Canadian curriculum. So you see there are other curricula available to address health literacy depending on what topic you're looking at, what region or what country or what context. And in Canada, there is this mental health and high school curriculum guide called the guide. We have translated it to German and also did an implementation and evaluation pilot in the past year. We are already doing, we are at the moment doing the analysis, but based on initial results, we can already see that implementing this intervention has positive effects on mental health literacy of both children and teachers. So you can see, you can also address health literacy in context of mental health promotion in particular mental health literacy, for example, to address stigma and mental illness. So these are components of our intervention. Understanding mental health and mental illnesses, the information on specific mental illnesses, experiences made. So there is a social and emotional component in, but you can also help students to become competent to seek for health in emergency cases and mental health cases, finding support and also why it is so important to have a positive connotation, a positive picture of mental health in order to avoid shame, victim blaming, et cetera, et cetera. So you see, and all the interventions that I've just shown you, they are for both. They are for children, right? To strengthen their health literacy capacities on the behavioral level, but when you take the school perspective or the perspective towards the professionals to the children, you can address the teacher competences to help the children to develop better health literacy skills. So you're on the environmental, on the systemic level, on the other side of the relational model. And how important the professionals in the educational setting are, such as yourself, the teachers, and maybe some of you are also school principals, I will show you on the following slides. We have conducted also some studies in school principals before the pandemic and during the pandemic. And here you see some results that we have generated during the pandemic, the health literacy, the overall health literacy is what you see in the highest bar, the overall health literacy. And you can see while 60% of the principals have very high health literacy, there is 40% of school principals stating that they have either inadequate or problematic health literacy with the evaluation, the appraisal dimension being the most difficult. So it's the same with in other adults related population health literacy studies in adolescents health literacy studies or children health literacy studies. Despite the fact that some individuals or whole populations have high levels of health literacy, they in fact always have problems with appraising health information. And interestingly in the different studies that we have conducted, we could find out that the higher level of health literacy in a school principal was always positively associated with more frequent implementation of school health promotion and prevention programs. So this alone makes health literacy of school principals a very important target, right? We have to promote to strengthen health literacy on school principals in context of child health. This is when we are on the right side of the relational models. And so this figure that you see here is just a different display of what I just told you. The green bars are the school principals with the high health literacy. And you can see on the left-hand side, these are the student, the children centered health promotion and prevention activities. In the middle, you see those directed as teachers or other school staff. And on the right-hand side, you see whole of school approaches. And in all of them, you can see there is a greater implementation of these measures when the principals have high levels of health literacy. So you see how important they are. And you see also how important the environmental level of the health literacy concept is. And this brings me to my next project. Health Literate Schools. This project aims at developing a concept for organizational health literacy of schools. And in fact, we did that in the past years. And at the moment, we are conducting a pilot survey in Germany and preparing our manuals, our tool boxes, all the materials for the schools, et cetera. And in our model, we have defined together with teachers, with principals, with other professionals from the education fields, but also with researchers and policymakers, the eight standards of a health literate school. I won't read them all. I just want to show you, there are eight standards and except standard four and five, all the standards aim at the structural at the environmental level of school. But of course, like any structural health promotion or setting approach, we always also have behavior as a component. So we want to strengthen personal health literacy of students, but also health literacy of teachers and principals. I've just shown you how important that is. And probably sometimes also early next year, we will have the results. These materials are also open access. You can access them on our website and use them in your own context. And this is a definition of the health literate school. A health literate school enables everyone involved in this school, including the students, the teachers, the principals, the parents, everybody involved to deal with and manage health information and to improve and reinforce health literate action and behavior. And you can see on the right-hand side, the green definition, this is the original definition of organizational health literacy. And for schools, it is the organizational health literacy of schools. So I believe that this approach, the organizational health literacy approach of schools is a very important approach because it's a systemic, setting-based approach. And I also want to introduce you to an Alliance, Alliance Health Literacy in Schools, which we have established in Germany, but also in the international context. Many organizations have declared their interest to work with us in this Alliance. And our main aim is to advance the evidence base. Remember the very first slide that I've shown you. Our aim is to advance the evidence-based on health literacy, develop strategies how to implement health literacy in schools in different countries to create a knowledge base. And of course, the global Alliance, we want to advocate for health literacy across countries in a school setting to increase the global awareness and also to build capacity. For example, it's an open network, everybody can join us. And I believe that these kind of approaches, these kinds of networks and alliances are all hands on deck jobs. So the more people engage with it, the more likely it will be that we'll be able to accomplish our goals. So, and I have reached my last slides, my conclusions, of course, health literacy is a very important topic for schools and education, both for the classroom, right? Teaching the personal health literacy skills, but also in teacher training and addressing organizational health literacy of schools. So the structures that demand the determinants of health. And we have seen that principles are key actors in all this kind of health promotion and health literacy approach, but we also need educational policies supporting the school setting. We could also see that health literacy is very important to some important mega trends or challenges in health, such as NCDs, infectious disease, such as COVID-19 in context of health promotion, but also the rise of the commercial determinants, the ecologic determinants, the digital determinants of health, right? And these are the things we have to keep in mind when we address health literacy. Thank you so much. And I hope that there is still time to have a proper discussion. Let me just stop my screen sharing. Yes, there is. Thank you. First of all, Dr. Orkan for the great talk. We do have a few questions for you. The first one is, does increasing health literacy in school-age children increase the proportion of kids that become interested in health-related careers? Oh, can you repeat the question? Is it in the chat box also? It's also in the chat box as well. Okay, but please just repeat it. Does increasing health literacy in school-age children increase the proportion of kids that become interested in health-related careers? Ah, so that they later become health professionals, medical or public health professionals themselves. Actually, as I said, health literacy, in particular, health literacy in schools and in children is a rather new topic. And I don't know of any study that is pursuing this kind of research question, but of course it would be very important to exactly conduct these kinds of studies. For example, in adults, we see that there are some associations, higher levels of health literacy in health professionals. So at least we can see that there is something to it, and it would be interesting to see if there is any relationship between higher levels of health literacy in early age and future career in the health sector. Okay, another question. Is there evidence showing a relationship between children's and adolescent's health literacy and their parents' health literacy? Would it be interesting to work to improve the parents' health literacy and to try and find the changes in the children's health literacy? Yeah, totally. There are many studies available in particular from the U.S. from North America on parental health literacy. Even it has a name of its own. This field of research, parental health literacy, maternal health literacy, paternal health literacy. When you look at mothers' father's health literacy or the health literacy system of the family system. And in fact, really, there is a relationship and we know that parents and mothers and fathers are the surrogate interface for their children to interact with the health care sector, with health professionals, and in terms of schools also with the educational professionals. And it is worth investing in parental health literacy. It sure will also have an impact on children's health development. For example, in the mom-child and kids studies, this is the study in primary school children, we could see that there is a positive relationship between high levels of health literacy and talking, so let's phrase it differently, those children with higher levels of health literacy also had more often talks, discussions with their children, with their parents on health matters. They were talking more with them or the parents were talking more with the children about health issues. So we can clearly see that parents are very important to children's not only health, but also to their socialization, to their education and to their proper and healthy development. Yeah, I mean, yeah, of course. I mean, if they have more, they're talking about this in more places than just school. Yeah, of course, we can see a positive relationship. And the last question is the Canadian guide and open resource. Actually, in part it is, you have to contact the office in Canada to access it. It is already available in many, many languages. It has been translated really to a lot of context and a lot of countries, also in Europe, but you just have to contact the office, the Canadian office. Just search for the guide or the mental health curriculum or mental health literacy in Canada. Then you will easily find it on Google and you have to contact the office. This whole program was developed by Stanley Kutcher and he is a former professor in Canada. Now he's a senator, so now he's in politics in Canada, but his coworkers still work on it and you just have to make contact with them and I'm sure they will grant you access or point you to an already available translation in your country that you can use. Okay. Thank you. Thank you very much. As you can see in the chat, I think a lot of people really enjoyed this presentation and got a lot out of it. As my colleague, Maria Elena, has already said in the chat, this webinar has been recorded and it will be uploaded to the page on ESSEP and also if you guys could please fill out the evaluation form that my colleague will also share in the chat now to let us know your experience during the webinar and if there are no further questions. Oh, we have one question. How can we contact you in person, Dr. Orkan, to discuss about embedding health literacy in school curriculum? Yeah, in fact, I really would be happy if as many of you would contact me and would have interest to address health literacy in particular also organizational health literacy. Just write an email. I can, let me just post my email to the chat box. So this is the best way to reach me but I'm also on Twitter or Mustadum, et cetera. Linked in, you can contact me there and we also have a working group on health literacy at the Eufa, the European Public Health Association. You can join us at the International Health Literacy Association where we have an interest group on health literacy in schools and there's also a lot of local work done in European countries. You can also join the SHE network. So there are many opportunities or even our COVID health literacy network. So plenty, plenty, plenty of opportunities how to collaborate. And I really would be happy if as many of you contact me, as many of you as possible. That would be awesome. Okay. All right. Well, we are finishing maybe a few minutes early but once again, thank you everybody for joining us and have a nice evening.