According to Susan, President of Society of Behavioural Health Singapore, to combat sedentary lifestyles, health education programs should be redesigned to incorporate applied learning and competency-based education. Raising awareness alone is no longer enough; true behaviour change requires emotive, experiential, and contextualised learning. Drawing from the works of David Kolb, Donald Schön, and John Dewey, Susan emphasises that learning is most effective when students engage in real-life applications.

Schools can reduce sedentary behaviour by designing lessons that discourage prolonged sitting, even in theory-based health classes. Grading should reflect both conceptual understanding and the application of health behaviours, such as meeting national physical activity guidelines. Physical activity should also be integrated into daily routines, not just limited to isolated physical education periods.

Deci and Ryan’s Self-Determination Theory suggests that long-term motivation is driven by:

• Autonomy: Students should have a say in the type and timing of physical activities.
• Competence: Students must be equipped with the necessary skills.
• Relatedness: Students should feel supported by peers and mentors.

This requires schools to rethink policies, schedules, and even classroom layouts. Could students be allowed to stand or walk during lessons without disrupting class?

To reduce chronic disease risks, schools should adopt a Lifestyle Medicine framework, integrating physical education and health education into a holistic wellness system. The six pillars of lifestyle medicine, including healthy nutrition, physical activity, stress management, restorative sleep, positive social relationships, and substance abuse prevention, should be taught as interconnected factors that impact overall health.

In summary, to foster lasting behaviour change, schools are encouraged to:

• Redesign health education with experiential learning
• Use role modelling from educators and leaders
• Foster autonomy and competence in students' activity choices
• Create environments that normalise movement and healthy eating
• Integrate lifestyle medicine into the curriculum

By doing so—healthy living becomes an empowered, natural part of a young person’s life, laying the foundation for better long-term health.

Susan, with her extensive experience in health promotion, explains that the knowledge-action gap exists across all age groups. A powerful example of this is Ogilvy Thailand’s “Smoking Kid” campaign, which won a Bronze Lion at the 2012 Cannes Lions. The campaign involved a hidden-camera social experiment where children approached adult smokers asking for a light, only to confront them with the note: “You worry about me. But why not yourself?” The shock of the interaction led many smokers to reflect on their own choices, with calls to quit hotlines increasing by 40% shortly after the ad aired. This emotional resonance, rather than preaching, had a profound impact and went viral globally.

Ogilvy—applied this same principle in Singapore’s “I Quit” campaign, focusing on real-life stories of individuals who had successfully quit smoking. The campaign used personal narratives rather than just health statistics, invoking themes of family, identity, and transformation. It was integrated across multiple platforms, including TV commercials, MRT ads, community roadshows, and social media challenges, creating a social norm around quitting smoking. Participants were encouraged to take public pledges, and the multi-channel support system led to a significant response, with thousands pledging to quit.

This approach illustrates how emotionally compelling messaging can drive behavioural change far more effectively than knowledge alone. As Harvard Professor Gerald Zaltman argues, human decisions are largely driven by emotions, which influence attention, perception, and motivation. Successful campaigns inspire, rather than simply inform.

Susan highlights that to design health education that truly changes lives, inspiration must be at the core. Teachers must move beyond simply delivering knowledge and embody healthy behaviours themselves. According to Albert Bandura’s Social Cognitive Theory, behavioural change is strongly influenced by modelling, meaning teachers must model healthy living and communicate it with passion and conviction.

Health education must evolve from textbook-based lessons to carefully designed experiences that incorporate:

• Appropriate emotionally compelling narratives
• Identity-reinforcing messages
• Experiential learning
• Reflection and peer interaction

In this model, students are no longer just processors of information; they are individuals who connect with stories. Teachers become facilitators, guiding students to find meaning, purpose, and vision in adopting healthy behaviours.

Early health education is crucial in laying the foundation for lifelong healthy habits. However, for it to be effective, it must go beyond theoretical learning. As Jean Piaget’s theory of constructivism suggests, children actively construct understanding through lived experiences, shaped by their cognitive development stages. Thus, health education must be developmentally appropriate, interactive, and relevant to their everyday lives.

Empowering students to adopt healthier habits requires more than just awareness of health risks. Sørensen et al.’s (2012) integrated model of health literacy highlights four key competencies:

• Accessing health information
• Understanding its meaning
• Appraising and interpreting its relevance
• Applying it to make decisions

Most health education programmes focus on knowledge and comprehension, neglecting the critical steps of appraisal and application, where real behaviour change begins.

Application, however, is never context-free. A student may understand healthy eating principles—like using “My Healthy Plate”—but if available food options at school or home conflict with this message, the student remains disempowered, despite their knowledge. Social determinants of health (SDOH), such as family norms, income, and parental habits, play a key role in whether a child can translate knowledge into action.

For instance, a student may learn to build a balanced salad bowl in class, but without access to affordable, available, and socially reinforced ingredients at home, the likelihood of adopting this behaviour is low. Health education must align with real-life environments to be impactful.

Therefore, effective early health education should:

• Equip students with critical thinking and appraisal skills
• Offer practical, low-barrier strategies for real-life application
• Involve caregivers and families in reinforcing healthy habits
• Address inequities in access to health-supportive resources

By doing so, early health education doesn’t just inform. It empowers, fostering the skills and confidence students need to make better health decisions into adolescence and adulthood.

According to Susan, creating a supportive environment for sustainable behaviour change requires schools to extend health education beyond the classroom and into the community. This approach aligns with Singapore’s vision of becoming a “Blue Zone 3.0.” By embedding applied learning into real-life settings, schools can partner with:

• Supermarkets for guided tours teaching food label literacy and smart grocery choices
• Hawker centres for hands-on activities to assess healthier food options and portion sizes
• Senior activity centres for intergenerational wellness projects

These collaborations reinforce knowledge and provide opportunities for students to advocate health within their families and communities. Imagine students co-creating healthier recipes with seniors or engaging in intergenerational sports challenges like badminton, table tennis, or pickleball, which strengthen both physical activity and social bonds across age groups.

Schools can also partner with healthcare institutions and rehabilitation centres to bring real-life stories into the learning experience. Reflecting on Susan’s time as a Quit Smoking Counsellor at the Health Promotion Board, she recalls a conversation with a 7-year-old about the harms of smoking. Today, we see rising youth vaping, which is at times met with leniency. But we must ask: Would the same leniency apply if these youths were caught with recreational drugs at age 21?

This is where narrative-based education can make a difference. Inviting rehabilitated former drug users, cancer survivors, or those affected by substance abuse to share their experiences can humanise the consequences of harmful behaviours. As Harvard professor Gerald Zaltman reminds us, humans are narrative thinkers, and we remember stories more than data points. These emotionally resonant accounts can challenge assumptions, provoke reflection, and inspire better choices.

To shift health behaviours, schools, community organisations, and healthcare systems must act as a unified ecosystem, reinforcing shared values, aligned messaging, and access to supportive environments. When students see healthy behaviours taught, lived, and supported across the places they learn, live, and play, they are more likely to adopt and sustain these habits into adulthood.