Pensar Enfermagem / v.29 n.01 / Jan-Dec 2025
DOI: 10.71861/pensarenf.v29i1.368 /e00368
Qualitative Original Article
How to cite this article: Galamba R, Bacatum C, Sousa E. Physical activity promoting mental well-being
among adolescents: A community-based school nursing intervention. Pensar Enf [Internet]. 2025 Jan-Dec;
29(1): e00368. Available from: https://doi.org/10.71861/pensarenf.v29i1.368
Physical activity promoting mental well-being
among adolescents: A community-based school
nursing intervention
Abstract
Introduction
Sedentary behavior among adolescents is a growing public health concern that calls for
urgent intervention, as it contributes to both physical and mental health problems and
directly affects adolescents’ quality of life. External factors such as parental support,
parents’ health literacy, and frequent screen use negatively influence the adoption of regular
physical activity. As this issue becomes increasingly prevalent among adolescents,
community and public health nurses play a key role in school settings by promoting health
literacy among young people and actively supporting behavior change through
empowerment strategies.
Objective
To equip 8th-grade adolescents with the knowledge and skills to adopt healthy
physical activity habits that promote mental well-being.
Methods
The project was developed using the Health Planning Methodology and grounded in Nola
Pender’s Health Promotion Model. The situational assessment was carried out using the
Students’ Attitudes Toward Physical Education questionnaire and a focus group. A non-
probabilistic convenience sample of 10 students was obtained.
Results
Adolescents demonstrated limited knowledge about the importance of physical activity for
their overall development and mental well-being, and reported engaging in sedentary
behavior during their free time.
Conclusion
This school-based health promotion project increased adolescents’ knowledge of the topic
and empowered them to adopt healthier physical activity habits, contributing to long-term
behavior change and healthier lifestyles.
Keywords
Physical Activity; Mental Well-being; Adolescents; Community and Public Health Nursing.
Raquel Galamba1
orcid.org/0009-0005-0383-6537
Cláudia Bacatum2
orcid.org/0000-0002-6820-5403
Edmundo Sousa3
orcid.org/0000-0003-2136-4471
1 Master. ULSAR; Enfermagem de Saúde Comunitária,
Escola Superior de Enfermagem de Lisboa, Lisboa;
CIDNUR - Centro de Investigação, Inovação e
Desenvolvimento em Enfermagem de Lisboa, Lisboa,
Portugal.
2 Master. Departamento de Enfermagem de Saúde
Comunitária, Escola Superior de Enfermagem de
Lisboa, Lisboa; CIDNUR - Centro de Investigação,
Inovação e Desenvolvimento em Enfermagem de
Lisboa, Lisboa, Portugal.
3 PhD. Departamento de Enfermagem de Saúde
Comunitária, Escola Superior de Enfermagem de
Lisboa, Lisboa; CIDNUR - Centro de Investigação,
Inovação e Desenvolvimento em Enfermagem de
Lisboa, Lisboa, Portugal.
Corresponding author
Raquel Galamba
E-mail: rgalamba@campus.esel.pt
Received: 21/10/2024
Accepted: 23/07/2025
Editor: Pedro Lucas
Galamba, R.
Qualitative Original Article
Introduction
Adolescence is a period of significant physical and
emotional changes, during which young people undergo
experiences that may shape their development and have a
substantial impact on their mental well-being and overall
health. Globally, the World Health Organization (WHO)
estimates that 14% of adolescents aged 10 to 19 experience
a mental disorder, with anxiety being the most common
among those aged 15 to 19.1 Suicide is also one of the
leading causes of death during adolescence, highlighting
how critical this stage is for mental health, as adolescents
often engage in risky behaviors that may harm their
emotional well-being.
In Portugal, the 2015 National School Health Program
identified mental health as a priority area for intervention,
aiming to strengthen students’ socio-emotional skills by
promoting protective factors for lifelong health.2
According to the WHO, physical activity provides
important mental health benefits, helping to prevent
cognitive decline, depression, and anxiety.3 However,
physical inactivity remains highly prevalent among
Portuguese adolescents: WHO data indicate that 78% of
boys and 91% of girls do not meet the recommended levels
of physical activity.4 Physical activity plays a key role in
maintaining well-being and promoting healthy behaviors,
making it essential to foster regular participation in physical
activity during adolescence.
The COVID-19 pandemic further emphasized the
importance of encouraging physical activity, as this
behavior is now recognized as a key determinant of both
physical and mental health.5 Pender et al. state that regular
physical activity among adolescents helps reduce depressive
symptoms and cognitive decline while enhancing overall
well-being.6 Physical activity serves as a protective factor
for mental health, whereas physical inactivity may
contribute to the development of mental health problems.7
Multiple factors can negatively influence adolescents’
attitudes toward physical activity. One primary concern is
technology dependence, particularly the excessive use of
social media, video games, and television, which directly
affects adolescents’ quality of life. Adolescents who spend
more than two hours per day in front of screens tend to
report poorer mental health outcomes.8 A study by
Chortatos et al.9 found that those who spent less time on
multimedia activities (such as TV/movie streaming or
gaming) were significantly more likely to participate in
physical activity during the week or on weekends. These
findings highlight the harmful effects of excessive screen
time on adolescents’ daily lives and reinforce the need for
interventions that promote healthy lifestyle habits.
Family influence is also a key factor in shaping adolescents’
physical activity behaviors. In a study by Kefeliçol and
Altay,10 adolescents whose parents had higher educational
attainment and strong family relationships were more likely
to engage in healthy behaviors. The study also found that
adolescents who did not live in nuclear families reported
fewer healthy habits compared to those who did. These
results are supported by Sollerhed et al.,11 who noted that
adolescents with good subjective health, higher levels of
physical activity, and greater satisfaction with school tended
to come from families with stable financial conditions. In
contrast, adolescents whose parents had lower levels of
education were more likely to spend excessive time in front
of screens.9
Sedentary behavior among adolescents has become an
increasingly pressing public health concern, with significant
physical and mental health consequences. It is well
established that sedentary lifestyles are a risk factor for
anxiety, depression, cardiovascular disease, and type 2
diabetes, and are also associated with depressive symptoms,
suicide attempts, and premature death in adolescents and
young adults.12,13 Pontes et al. also point out that physical
inactivity is more prevalent among girls than among boys.13
In addition to its well-established contribution to the
healthy growth and development of children and
adolescents, regular physical activity fosters the
development of social skills and provides numerous
psychological, emotional, and cognitive benefits, with
positive effects on academic performance.12 Additionally,
Portuguese children and adolescents spend an average of
545 minutes per day engaged in sedentary activities.12
Regular physical activity contributes to the improvement of
positive health and lifelong well-being. As such, the school
years represent a unique opportunity to intervene and
prevent sedentary habits, since many unhealthy behaviors
are established in this period.12
Schools play a fundamental role in shaping adolescents, not
only in the academic domain but also in promoting health
and encouraging the adoption of healthy habits.
Nurses are the health professionals best positioned to lead
health promotion initiatives in school settings.6 Their close
relationship with the community is essential to the health
planning process, as it allows them to identify the
population’s actual needs and develop appropriate
strategies that equip individuals to adopt healthier lifestyles.
According to the principles set forth in the Ottawa
Charter,14 it is the responsibility of health professionals to
empower the population through health promotion,
enabling individuals to achieve their full health potential by
taking control of the factors that determine it.
This project is grounded in the European initiative
Promoting Mental Wellbeing through Online Exchange in Secondary
Schools (wExchange), co-funded by the European Union.
It was developed through a consortium of higher education
institutions and secondary schools in Finland, Slovenia,
Greece, and Portugal to promote adolescent mental well-
being through peer education. The present project aimed
to equip 8th-grade students with the knowledge and skills
to adopt healthy physical activity habits that support mental
well-being. Peer education was the core strategy employed
during the community intervention phase.
Methods
A cross-sectional observational study was conducted, based
on the Health Planning methodology proposed by
Pensar Enfermagem / v.29 n.01 / Jan-Dec 2025
DOI: 10.71861/pensarenf.v29i1.368 /e00368
Imperatori and Giraldes and theoretically grounded in Nola
Pender’s Health Promotion Model (HPM).
According to Imperatori and Giraldes, health planning
arises from the need to manage limited available resources
in order to address prioritized health problems through
collaborative efforts with other community sectors.15
Health planning is characterized as a continuous process
that coordinates the necessary resources and enables the
selection of the most appropriate solutions to achieve the
desired health outcomes.16 The HPM proved essential
throughout the process and was applied at every stage of
health planning. This theoretical model emphasizes that
health behavior change is an intrinsic ability of each
individual, who possesses the potential for change through
self-knowledge, self-regulation, problem-solving, and
decision-making.6
The project was developed within the catchment area of a
Local Health Unit, through the Public Health Unit and the
Community Care Unit, in partnership with a secondary
school within a public school cluster.
The study population consisted of 8th-grade students from
a secondary school in the municipality of Barreiro. The
target population consisted of all 8th-grade students
enrolled at this school during the 2023–2024 academic year.
The sample was obtained through purposive (convenience)
sampling and comprised 10 students. This sample was
obtained by administering the questionnaire to four
8th-grade classes. Those classes that did not participate
were excluded because their parents or legal guardians did
not provide consent.
Inclusion criteria were: being an 8th-grade student in the
2023–2024 academic year; having reading and writing skills;
having completed the questionnaire; and having a signed
informed consent form from a parent or legal guardian.
Exclusion criteria were: lack of signed parental consent,
lack of interest in participating in the study, or not being an
8th-grade student.
Health research requires compliance with ethical principles
governing all activities involving participants. The
adolescents were informed about the purpose of the
project, the potential risks and benefits of their
participation, and their right to decline or withdraw from
the study at any time without consequences. Those who
agreed to participate signed an informed assent form, and
their parents or legal guardians signed the informed consent
form.
Authorization was requested from the Primary Healthcare
Group, the Public Health Unit, and the School Cluster. The
study was also submitted to the Health Ethics Committee
of the Regional Health Administration of Lisbon and Tagus
Valley (protocol no. 060/CES/INV/2023), which issued a
favorable opinion on December 15, 2023.
Because the project involved collaboration with other
professionals—specifically, teachers from the School
Cluster and a nurse from the Public Health Unit—a formal
commitment statement was prepared and signed by all
parties involved.
Data collection for the situational diagnosis took place in
December 2023 using a structured questionnaire consisting
of two sections. Section A focused on the participants’
sociodemographic characteristics, while Section B
contained the “Student Attitudes Toward Physical
Education Questionnaire” (QAAEF), developed by Pereira
et al.17
Section A gathered sociodemographic information. For the
two open-ended questions, the responses were coded by
creating new variables based on the main categories
identified in the answers. Section B comprised 10 items: 7
assessing students’ enjoyment of physical education and 3
evaluating the importance they assigned to the subject.
Seven statements were positively worded, and three were
negatively worded. Each item was rated on a 5-point Likert
scale: 1 – strongly disagree, 2 – disagree, 3 – neither agree
nor disagree, 4 – agree, and 5 – strongly agree.
A focus group session was also conducted in January 2024
to supplement the data collected for the situational
diagnosis. This qualitative data collection technique is
based on participants’ spontaneous sharing of opinions on
a specific topic, allowing for open discussion and the
extraction of relevant insights. It can be applied at any stage
of the research process.19 Participants were selected based
on characteristics relevant to the topic under discussion and
their potential to provide valuable contributions to the
study.
Data analysis was conducted using descriptive statistics,
including measures of central tendency and dispersion. The
analysis was performed using IBM SPSS (Statistical
Package for the Social Sciences) Statistics 28, and the data
were processed between December 2023 and January 2024.
Results
The sample (n = 58) consisted of students aged between 11
and 16 years: 1 student was 11 years old (1.7%), 2 were 12
(3.4%), 41 were 13 (70.7%), 11 were 14 (19%), 1 was 15
(1.7%), and 2 were 16 (3.4%). The mean age was 13.26
years, the mode was 13, and the standard deviation was
0.78. Regarding sex, the sample included 30 girls (51.7%)
and 28 boys (48.3%).
In terms of family composition, 34 students (58.6%)
belonged to nuclear families, 14 (24.1%) to single-parent
families, 3 (5.2%) to extended families, 4 (6.9%) to blended
families, and 3 (5.2%) to dual-caregiver households.
Regarding parents’ educational attainment, 3.4% had
completed primary school (1st cycle), 3.4% had completed
lower secondary (2nd cycle), 46.6% had completed upper
secondary (3rd cycle), and 46.6% had attended higher
education.
As for how students spent their free time, 24.1% reported
playing games, 36.2% engaged in sports, while 63.8% stated
they did not practice any sport. Additionally, 56.9% spent
their free time on leisure activities, and 22.4% reported
engaging in rest-related activities.
Regarding the “Students’ Attitudes Toward Physical
Education” questionnaire, differences were found between
boys and girls in terms of enjoyment and the importance
attributed to physical education. In question B1 – “I usually
have fun in physical education class” – 31.03% of boys
Galamba, R.
Qualitative Original Article
strongly agreed, compared to only 10.34% of girls. For B2
– “I like physical education class” – 36.21% of boys and
20.69% of girls strongly agreed. In B3 – “Time goes by
quickly in physical education class” – 36.21% of boys
strongly agreed versus 20.69% of girls. For B4 – “I like the
topics covered in physical education” – 27.59% of boys
strongly agreed, while only 8.62% of girls gave the same
response. In B5 – “Physical education is one of my favorite
subjects” – 37.93% of boys strongly agreed compared to
just 12.07% of girls. For B6 – “I usually get bored in
physical education class” – 32.76% of boys strongly
disagreed, 10.34% of girls strongly disagreed, and 20.69%
neither agreed nor disagreed. In B7 – “I usually wish
physical education class would end quickly” – 35.09% of
boys strongly disagreed, compared to just 14.04% of girls;
one response was missing for this item. In B8 – “Physical
education is important for my overall development” –
25.86% of boys and 13.79% of girls strongly agreed. In B9
– “Physical education is as important as other subjects” –
31.03% of boys and 18.97% of girls strongly agreed. Finally,
in B10 – “Compared to other subjects, physical education
is one of the least important for my overall development”
– 19.30% of boys strongly disagreed, 14.04% of girls
strongly disagreed, while 19.30% of girls neither agreed nor
disagreed. One response was also missing for this item.
The analysis of the focus group also revealed sedentary
behaviors and, most notably, a lack of knowledge regarding
the importance of regular physical activity for maintaining
mental well-being.
Based on the data analysis, the following health problems
emerged and formed the health diagnosis: lack of
knowledge about the importance of physical education for
overall development; lack of knowledge about the
relationship between physical activity and mental well-
being; presence of sedentary behaviors during free time;
and low interest in physical activity among girls. After
identifying these problems, two nursing diagnoses were
established: potential to improve knowledge about the
importance of physical activity for mental well-being and
presence of sedentary behavior. These nursing diagnoses
were formulated according to the 2015 version of the
ICNP® taxonomy.18
The priority-setting stage aimed to rank the identified
health problems in order to guide the intervention toward
those considered most urgent, based on the available
resources and timeframe.19 In this project, the pairwise
comparison method was selected, as it is suitable when
fewer than ten problems are identified. This step was
carried out with the support of a panel of experts—the
academic advisor and the pedagogical advisor—both
certified specialists in community nursing. According to
this method, each problem is successively compared with
the others, and the most important one is selected in each
comparison.15,19 Considering the time constraints of the
project, the decision was made to address the top two
prioritized problems, as they were interrelated and feasible
to tackle: lack of knowledge about the relationship between
physical activity and mental well-being, and the presence of
sedentary behaviors during free time. Based on this
prioritization, the intervention focused on increasing
adolescents’ knowledge about the role of physical activity
in promoting mental well-being and raising awareness
about the consequences of sedentary behavior.
The strategy selection phase aimed to address the identified
health needs through targeted interventions aligned with
the project’s objectives.19 The chosen strategy was health
education, designed to empower adolescents by enhancing
their health literacy, particularly regarding the importance
of physical activity as part of a healthy lifestyle that
promotes mental well-being. This strategy was
implemented through health education sessions conducted
in the school setting with the adolescents who participated
in the project and comprised the study sample. A peer
education approach was also adopted, reinforcing the
positive impact that adolescents can have on collective
action and behavior change, as described by Pender et al.6
Sharing information among peers enables knowledge to
reach a broader group of adolescents through a less
hierarchical, more inclusive, and interactive learning
environment. This approach also promotes the
development of responsibility, which is fundamental in
adolescence for the development of social skills. This is
because adolescents play an active role in the transmission
of knowledge, becoming accountable not only for their
peers’ learning but also for their own.
Additionally, a health dissemination strategy was
incorporated through the development of an e-book
targeted at peer educators, which was sent via email (a
communication method already used between students and
teachers) to enable continuity of the project among their
peers. A poster promoting physical activity among
adolescents was also created and shared via email with the
students who participated in the project.
Discussion
The WHO recommends that adolescents engage in at least
60 minutes of moderate to vigorous physical activity per
day.3 According to the study by Gaspar et al.,20 which
compares findings from the 2018 and 2022 surveys, there
was an increase in the number of adolescents reporting
sports participation three to six times a week, from 52.5%
to 56.3%, respectively. However, 18.4% of respondents
reported never having participated in any sport. The same
study also noted a decrease in perceived happiness
compared to 2018, with 27.7% of adolescents reporting
feeling unhappy, 21% feeling nervous, 15.8% experiencing
irritation or bad moods, and 11.6% feeling sad almost
every day.20
These findings reveal that physical activity remains
inconsistent in the daily lives of adolescents, highlighting
how young people perceive their emotional well-being,
Pensar Enfermagem / v.29 n.01 / Jan-Dec 2025
DOI: 10.71861/pensarenf.v29i1.368 /e00368
with a considerable proportion reporting negative feelings.
The analysis of the present study revealed that some
students place little value on physical education for their
overall development, which contributes to a diminished
perception of the importance of physical activity in their
developmental process, alongside the presence of sedentary
behaviors.
Most adolescents reported spending their free time engaged
in leisure, rest, or computer games—activities that do not
involve movement or physical effort—instead of
participating in physical activity or sports. In this sample, a
considerable percentage (63.8%) reported not engaging in
any sports during their free time.
These results are consistent with WHO data showing high
levels of physical inactivity among Portuguese adolescents,4
as well as with the study by Gaspar et al., which found that
18.4% of respondents had never practiced any sport.20 The
results also suggest that the importance adolescents assign
to physical activity varies by sex. Boys demonstrated greater
interest in physical education and placed more value on
engaging in physical activity for their overall development
and education compared to girls.
These findings are consistent with those from the scoping
review conducted by Pontes, which clearly indicated that
physical inactivity is more prevalent among girls than
boys.13 Overall, the dimension related to enjoyment of
physical education and its content showed higher levels of
agreement, while the dimension concerning the importance
of physical education revealed that some students
expressed indecision, selecting “neither agree nor disagree.”
These findings underscore the need for intervention with
this community group to promote physical activity habits
and enhance health literacy. Promoting positive attitudes
toward physical activity can foster the adoption and
maintenance of healthy behaviors during adolescence.17
Such results highlight the importance of school-based
interventions led by health professionals to improve
adolescents’ health literacy and prevent declines in mental
well-being that may develop into mental health disorders in
the future. Although it was not possible to assess behavioral
changes or health gains, and in order to carry out the final
stage of health planning, process/activity and
outcome/impact indicators were defined, as recommended
by Imperatori and Giraldes,15 aligning with the proposed
objectives and targets.
After the health education sessions, the students
completed a knowledge assessment questionnaire and a
satisfaction questionnaire regarding the sessions. All
process or activity indicators were achieved, as shown in
Table 1. The two planned sessions were conducted, and all
the expected students—that is, the peer educators—were
present at both. The goal of distributing the informational
poster and the e-book was also met, as both were shared
with all the students for whom they were intended.
Regarding the outcome or impact indicators, all were
achieved: in the peer education session, 80% of the
adolescents were able to identify at least one appropriate
dynamic activity that could be implemented. In the
“Actively” session, 100% of the adolescents identified three
benefits of physical activity for health and three
consequences of sedentary behavior, and 80% were able to
identify two sedentary behaviors. The results for the
defined indicators underscore that the first step
toward behavior change—knowledge acquisition—was
accomplished. However, such a change will only be
possible if adolescents are properly empowered by
acquiring health literacy to make healthier decisions in the
future.
These results show that it was possible to increase
adolescents’ knowledge about the importance of physical
activity for health, as well as about the peer education
strategy, which forms the basis for continuing this project.
Health promotion, when combined with the peer education
strategy, has a positive impact on adolescents’ motivation
and, consequently, on the actual modification of certain
behaviors.21
Galamba, R.
Qualitative Original Article
Table 1 – Evaluation of the defined indicators
Conclusion
This project made valuable contributions in three key areas.
First, it supported the target community by increasing
adolescents’ health literacy. Second, it contributed to
nursing research by clearly demonstrating the nurse’s role
in advancing knowledge through the development of a
community health diagnosis and the implementation of a
health promotion project, both of which deepened
understanding of population health and quality of life.
Ultimately, it strengthened clinical practice in community
nursing by improving professionals’ capacity to plan,
manage, and carry out interventions based on the needs
identified within the population. The focus of community
and public health nursing is to improve the population’s
health conditions and continuously enhance the quality of
care, which in turn supports the advancement of nursing as
a constantly evolving science.
In her Health Promotion Model (HPM), Nola Pender
emphasizes that the school environment is a setting where
a salutogenic approach to health promotion calls for
comprehensive and ongoing interventions aimed at
fostering early awareness of the importance of adopting
healthy behaviors.6 The development of health-promoting
or harmful behaviors during adolescence is directly
influenced by the surrounding social environment and by
the connection between family and school. Ensuring
positive support systems can mitigate the risks inherent to
this life stage.6 Based on this theoretical framework, the
need to promote physical activity among adolescents
becomes evident, especially considering the results from
the questionnaire and focus group, which revealed a lack of
knowledge about the impact of physical activity on mental
well-being and on healthy growth and development.
Since sedentary behavior is highly prevalent among
adolescents, as evidenced in the literature, this project has
added social value by promoting health empowerment and
raising awareness about the importance of behavior change
in preventing sedentary lifestyles. The questionnaire results,
when cross-analyzed with findings from the literature
review, showed that adolescents tend to have a less
favorable attitude toward integrating physical activity into
their daily routines. This finding highlights the need to raise
their awareness of the importance of becoming active
agents in making informed and conscious decisions.
Encouraging awareness of healthy lifestyle choices fosters
opportunities for both personal and social growth. As peer
influencers within their communities, adolescents are
well-positioned to build positive relationships, share
knowledge, and foster cohesion among peers.
The Alma-Ata Declaration22 emphasized the importance of
primary healthcare, recognizing health promotion and
community engagement as essential to achieving health for
all. The strategies selected for this project align with this
principle by reinforcing the need for early community
involvement, empowering individuals to make informed,
conscious, and health-promoting decisions. Health
promotion serves as the starting point for reducing the
future burden of health problems among adolescents,
enabling them to reach their full health potential. The role
of the community health nurse is crucial in primary care, as
they actively promote health within the population and
establish key partnerships to support the achievement of
shared goals.
As outlined in the core competencies of specialist nurses in
community and public health nursing, these professionals
are expected to take on leadership roles in
community-based processes that aim to empower the
population and mobilize community partners involved in
identifying and addressing health problems.23
The objectives of this project were achieved, as all
proposed indicators were met. The adolescents also
demonstrated a clear interest in the topic, as reflected in
their satisfaction and engagement throughout the process.
These findings underscore the need for additional school-
based projects that aim to empower adolescents to develop
autonomy in their decision-making and take greater
Process or activity indicators
Target
Result
Number of health education
sessions conducted / number of
planned health education
sessions × 100%
Conduct 100%
of the planned
sessions
100%
Number of adolescents expected
to attend the “peer education”
session / number of adolescents
present at the session × 100%
10 students
(peer educators)
100%
Number of adolescents expected
to attend the “Actively” session
/ number of adolescents present
at the session × 100%
10 students
(peer educators)
100%
Number of adolescents to
whom the informational poster
was made available / total
number of students × 100%
At least 80% of
the students
100%
Number of adolescents to
whom the e-book was made
available / total number of
students × 100%
100% (peer
educators)
100%
Outcome or impact indicators
Target
Result
Number of adolescents who
identified one appropriate
dynamic activity in the peer
education session / total
number of adolescents × 100%
70%
80%
Number of adolescents who
identified three benefits of
physical activity / total number
of adolescents × 100%
70%
100%
Number of adolescents who
identified three consequences of
sedentary behavior for health /
total number of adolescents ×
100%
70%
100%
Number of adolescents who
identified two sedentary
behaviors / total number of
adolescents × 100%
70%
80%
Pensar Enfermagem / v.29 n.01 / Jan-Dec 2025
DOI: 10.71861/pensarenf.v29i1.368 /e00368
responsibility for their own health. Targeting the social
determinants that influence population health is crucial to
maintaining community well-being and preventing risk
behaviors that may negatively affect individuals’ health.
This project is expected to continue, with potential
expansion to other classes so that the knowledge can reach
more adolescents and the desired health outcomes can be
achieved. The goal is for adolescents to make informed
decisions about leading an active lifestyle by incorporating
physical activity or exercise into their daily lives in ways that
match their abilities and routines. The implemented
strategies aim to raise their awareness of the benefits of an
active lifestyle compared to the risks associated with
sedentary habits, which are commonly observed during
adolescence.
Authorship and Contributions
RG: Conception and design of the study; Data collection;
Data analysis and interpretation; Statistical analysis; Writing
the manuscript.
CB: Data analysis and interpretation; Critical revision of the
manuscript.
ES: Conception and design of the study; Data analysis and
interpretation; Statistical analysis; Critical revision of the
manuscript.
Conflicts of interest and Funding
No conflicts of interest have been declared by the authors.
Sources of support / Financing
The study was not funded.
References
1. World Health Organization. World mental health report:
transforming mental health for all [Internet]. Geneva:
WHO; 2022 Jun [cited 2024 Jul 10]. 14 p. Available from:
https://www.who.int/publications/i/item/978924004933
8
2. Direção-Geral da Saúde. Programa Nacional de Saúde
Escolar [Internet]. Lisboa: DGS; 2015 Aug [cited 2024 Jul
8]. 11 p. Available from: https://www.dgs.pt/paginas-de-
sistema/saude-de-a-a-z/saudeescolar/programa-nacional-
de-saude-escolar.aspx
3. World Health Organization. WHO Guidelines on
physical activity and sedentary behaviour: at a glance
[Internet]. Geneva: WHO; 2020 Nov [cited 2024 Out 22]. 3
p. Available from:
https://www.who.int/publications/i/item/978924001488
6
4. World Health Organization. Physical activity profile 2022
Portugal [Internet]. Geneva: WHO; 2022 Jun [cited 2024
Out 22]. 1 p. Available from:
https://www.who.int/publications/m/item/physical-
activity-prt-2022- country-profile
5. Direção-Geral da Saúde. Programa Nacional para a
Promoção da Atividade Física [Internet]. Lisboa: DGS; 2022
Dez [cited 2024 Nov 15]. 14 p. Available from:
https://www.dgs.pt/pns-eprogramas/programas-de-
saude-prioritarios/atividade-fisica.asp
6. Pender N, Murdaugh C, Parsons M. Health promotion in
nursing practice. Boston: Pearson Education; 2015. 342 p.
7. Organisation for Economic Co-operation and
Development & European Union. Health at a glance:
Europe 2022: state of health in the EU cycle [Ebook on the
Internet]. Paris: Organisation for Economic Co-operation
and Development; 2022 Dez [cited 2024 Dez 2]. 33 p.
Available from: https://doi.org/10.1787/507433b0-en
8. Rodriguez-Ayllon M, Cadenas-Sánchez C, Estévez-López
F, Muñoz NE, Mora-Gonzalez J, Migueles JH, et al. Role of
physical activity and sedentary behavior in the mental health
of preschoolers, children and adolescents: a systematic
review and meta-analysis. Sports Med [Internet]. 2019 [cited
2024 Nov 6];(49):1383–1410. Available from:
https://doi.org/10.1007/s40279-019-01099-5
9. Chortatos A, Henjum S, Torheim LE, Terragni L,
Gebremariam MK. Comparing three screen-based
sedentary behaviours’ effect upon adolescents’ participation
in physical activity: the ESSENS study. PLoS ONE
[Internet]. 2020 [cited 2024 Nov 6];15(11):e0241887.
Available from:
https://doi.org/10.1371/journal.pone.0241887
10. Kefeliçol B, Altay B. The effect of family characteristics
of the adolescents upon their healthy lifestyle behaviors.
Turkiye Klinikleri Journal of Nursing Sciences [Internet].
2021 [cited 2024 Nov 10]; 13(3):564-71. Available from:
DOI: 10.5336/nurses.2020-78549
11. Sollerhed AC, Lilja E, Holmgren EH, Garmy P.
Subjective health, physical activity, body image and school
wellbeing among adolescents in south of Sweden. Nursing
Reports [Internet]. 2021 [cited 2024 Nov 10]; (11):811–822.
Available from: https://doi.org/10.3390/
nursrep11040076
12. Carvalho A, Matos C, Minderico C, Tavares de Almeida
C, Abrantes E, Mota EA, et al. Referencial de educação para
a saúde [Internet] Lisboa; DGE; 2017 Jun [cited 2006 Nov
2]. 51 p. Available from:
https://www.sns.gov.pt/noticias/2017/09/06/referencial-
deeducacao-para-a-saude
13. Pontes NMH, Williams WM, Pontes MCF. Interactions
between race/ethnicity and gender on physical activity
among us high school students: youth risk behavior survey
2011–2017. J Pediatr Nurs [Internet]. 2021 [cited 2024 Nov
7];(60):100–108. Available from:
https://doi.org/10.1016/j.pedn.2021.02.013 0882-5963
14. Organização Mundial de Saúde. Carta de Ottawa para a
promoção da saúde: 1ª Conferência Internacional sobre
Promoção da Saúde [Internet]. Otawa: OMS; 1986; [cited
2024 Out 3]. Available from:
https://www.dgs.pt/documentos-e-publicacoes/carta-de-
otawa-pdf1.aspx
Galamba, R.
Qualitative Original Article
15. Imperatori E, Giraldes M. Metodologia do planeamento
da saúde: manual para uso em serviços centrais, regionais e
locais. Lisboa: Escola Nacional de Saúde Pública; 1993.
16. Tavares, A. Métodos e técnicas de planeamento em
saúde. Lisboa: Ministério da Saúde; 1990.
17. Pereira P, Carreiro da Costa F, Diniz JA. As atitudes dos
alunos face à disciplina de educação física: um estudo
plurimetodológico. Boletim Sociedade Portuguesa de
Educação Física [Internet]. 2009 [cited 2024 Out 4]; (34):83-
94. Available from:
https://boletim.spef.pt/index.php/spef/article/view/132
18. International Council of Nurses. CIPE versão 2015:
Classificação Internacional para a Prática de Enfermagem
[Internet]. Lisboa: OE; 2016 Mai [cited 2024 Dez 19].
Available from:
https://futurosenf.files.wordpress.com/2017/04/cipe_201
5.pdf
19. Rodrigues F M. A saúde planeada: metodologia
colaborativa com a comunidade. 1ª ed. Lisboa. Lisbon
International Press; 2021.
20. Gaspar T, Guedes FB, Cerqueira A, Matos MG. A saúde
dos adolescentes portugueses em contexto de pandemia –
dados nacionais 2022 [Internet]. Lisboa: Aventura Social;
2022 Dez [cited 2024 Out 2]. Available from:
https://aventurasocial.com/dt_portfolios/a-saude-dos-
adolescentesportugueses-em-contexto-de-pandemia-dados-
nacionais-2022
21. Dias SF. Educação pelos pares: uma estratégia na
promoção da saúde. Lisboa: Universidade Nova de Lisboa;
2006
22. Organização Mundial de Saúde. Declaração de Alma-Ata
Conferência Internacional sobre Cuidados de Saúde
Primários [Internet]. Alma-Ata: OMS; 1978 [cited 2024 Dez
4]. Available from:
http://apps.who.int/iris/bitstream/handle/10665/39228/
9241800011_por.pdf
23. Regulamento n.º 428/2018. Regulamento de
competências específicas do enfermeiro especialista
em enfermagem comunitária na área de enfermagem
de saúde comunitária e de saúde pública e na área de
enfermagem de saúde familiar. Diário da República, II
Srie (nº 135 de 16-07-2018), 19354-19359. Available
from:
https://diariodarepublica.pt/dr/detalhe/regulament
o/428-2018-115698616