There are many reasons to focus on schools as a setting to promote the health of young people, including the inter-relationship between health and education, the commitment to health and synergy between the health and education sectors, the existence of evidence to support school health promotion, and the access to large numbers of students that schools provide. There remain, however, many challenges for school health promotion, including the potential to overcrowd the curriculum, the difficulty of engaging parents and community partners, issues of school or health ownership of programs and the practical dilemmas of evaluation. It is argued that rather than being reasons to avoid work in this setting, these challenges should inform intervention and broader program design.

Issue addressed: Physical activity levels in girls are known to decline from puberty onwards, with long-term adverse health implications. This project addressed the issue of physical inactivity in one girls' government high school with a population of more than 800 students from mainly non-English speaking backgrounds. Methods:The project used the results of a thorough needs assessment and strong partnerships to develop strategies to increase students' physical activity within the Health Promoting Schools framework. Strategies covered the curriculum, the physical, social and organisational environments of the school and partnerships, including links with parents and community agencies.Results: Evaluation used quantitative and qualitative methods. At post, a significantly higher percentage of the intervention group compared with a historical control group was moderately (adequately) active and a lower percentage was inadequately active (χ 2 =14.8, p<0.01). Changes in participation occurred during school hours. Rates of participation in many of the non-competitive activities introduced by the project increased. Conclusions:This study showed that physical activity levels of adolescent girls could be favourably influenced within the school setting. So what?Since adequate physical activity can have a positive preventive impact on a variety of lifestyle diseases, a project to increase physical activity levels among female adolescents could be expected to have long-term benefits. Why adolescent girls?Studies have shown that women are generally less physically active than men; the level of physical activity starts to decline as girls reach puberty and continues to do so throughout adolescence. 6,7 The 1997 New South Wales (NSW) Schools Fitness and Physical Activity Survey 8 found adolescent girls to be less physically active, less fit and to have poorer motor skills than boys. Factors that appear to contribute to this are socioeconomic status, attitudes, social norms, self-efficacy for physical activity, peer and family support and access to facilities. 9,10 Women from non-English speaking backgrounds were found to be less likely than women from English-speaking backgrounds to play sport. 11 Since health behaviours adopted in childhood and adolescence are carried into adulthood, 12 a project to increase physical activity levels among adolescent girls could be expected to have long-term benefits. 3

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SHIP developed partnerships between health, education sectors and schools, encouraged schools to adopt a whole-school approach to health issues, and supported the development of subsequent health-focused initiatives.