Co-constructing childhood obesity prevention policies: a participatory action-research model from the Portuguese Health4EUKids pilot.

This paper presents findings from the Portuguese pilot of the European Joint Action Health4EUKids, which tested participatory, multi-sectoral methods to design and implement policies for childhood obesity prevention. The action-research model implemented mobilized schools, families, municipalities, and health services to co-create interventions promoting children's biopsychosocial well-being. The assessment revealed that 66% of the children had a body mass index within the normal range, while 11% were overweight and 4% obese. Despite indicators of healthy eating habits, 36% of children did not meet WHO recommendations for daily physical activity. In terms of mental health, 57% reported irritability and 46.7% nervousness, although there were overall positive indicators of quality of life, well-being, and peer relationships. Differences were observed between sexes, with girls showing better levels of emotional well-being and boys showing greater involvement in physical activity. Screen dependence was moderate to high in about 50% of the sample, being more prevalent in urban areas. The application of the Living Healthy Tool revealed more favorable perceptions in rural areas while in urban areas greater barriers related to safety and access to sports infrastructures were identified. The study highlights the effectiveness of participatory governance for health promotion, offering policy pathways for actions on a national and European Union level.