The future of our society begins in the classroom. Not only do schools play a central role in the transmission of knowledge, but they also serve as key environments for understanding and promoting the health and well-being of children and adolescents [1]. Therefore, health-related research in schools (HRRS) is important for identifying current and future health issues and developing and evaluating preventive measures as well as cost-effective health programs. Schools provide unique settings for scientific research, as children and adolescents spend a substantial part of their daily lives there. The socioeconomic diversity within schools, encompassing factors such as parental education levels and household income, allows for the collection of more comprehensive data compared to specialized environments, such as sports or youth clubs [2]. Often, schools are the only option for studies that aim to draw conclusions about the general population of children and adolescents.

Research in school settings is critical for generating insights that support UNICEF’s and the UN’s third Sustainable Development Goal: SDG 3 – Good Health and Well-Being [3, 4], particularly sub-goal 3.4, which focuses on reducing mortality from non-communicable diseases and promoting mental health and well-being. HRRS enables a deeper understanding of the physical, mental, and social dimensions of health among children and adolescents, providing essential evidence to inform targeted interventions and health-promoting policies. This comprehensive approach is essential for developing effective strategies to promote the health and well-being of children and adolescents. It supports the early identification of health risks and the analysis of interrelated factors, which in turn inform the design of interventions, such as school-based health programs for children and adolescents [2, 5]. Ultimately, these efforts could contribute to long-term, sustainable improvements in their overall quality of life.

In 2019, an estimated 7%–14% of children and adolescents aged 5–19 years were affected by mental disorders [6], and clinical treatment for these disorders among children and adolescents has increased in recent decades [7]. In Switzerland, many teenagers face mental health challenges [8, 9] and report physical symptoms such as headaches, stomachaches, and back pain [10]. Furthermore, the majority of adolescents worldwide fail to meet recommended physical activity guidelines [11], a finding also reflected in a Swiss national study from 2019 [12]. Finally, the increasing global use of digital media introduces further health risks as higher levels of screen time are associated with reduced physical and psychosocial health among children and adolescents [13–15].

The Swiss context for HRRS is characterized by a unique blend of federalism, linguistic diversity, and a multicultural student population, alongside a dense network of public schools, with a limited number of private institutions. The federal structure distributes educational responsibilities among cantons, municipalities, and schools, which complicates the implementation of uniform health interventions. Switzerland’s educational system is highly decentralized, with 26 different scholastic systems coexisting within the same territory [16]. Such decentralization can complicate survey design and implementation, as researchers must navigate varying educational policies and structures across different cantons. Consequently, researchers often face challenges in identifying the appropriate stakeholders with whom to discuss their study plans. Additionally, many students and their families may not be native speakers of the local language, which creates barriers to effective communication and engagement in health initiatives [17]. With one of the highest proportions of foreign nationals in Europe, Swiss schools embody a rich tapestry of cultural backgrounds, presenting both challenges and opportunities for HRRS. This linguistic diversity necessitates tailored research approaches that accommodate multiple languages and cultural perspectives to ensure inclusivity and understanding [18].

Despite the need for HRRS, there are considerable challenges to overcome when conducting it. To the best of our knowledge, this is the first policy brief addressing how to improve the conduct of HRRS. First, we briefly summarized evidence of the challenges of conducting HRRS, with a particular focus on the Swiss context. Second, we outlined policy options across three main areas relevant to HRRS. Finally, we discussed potential barriers to and facilitators of the implementation of these policy options.

The National Health Report 2020 by the Swiss Health Observatory [19] presents six key recommendations, one of which emphasizes the need for the need for continuous data collection on children, adolescents, and young adults. Regular health data not only aids in the monitoring of health factors and outcomes but also allows for detailed analyses of their associations with learning outcomes and social determinants. Alongside routine data collection, targeted studies can address existing data gaps. Investing in the health and well-being of children and adolescents can yield significant benefits: for the present, in later adult life, and for future generations [1, 20]. Moreover, investments in children’s health can lead to reduced healthcare costs in the future by decreasing the prevalence of health problems [21, 22]. Healthy children are more likely to become healthy adults [19], which in turn brings long-term economic benefits to society [23]. For instance, childhood and adolescent overweight increases the risk of obesity and associated comorbidities in adulthood [24, 25].

Conducting HRRS is essential to understanding and addressing the future health issues faced by children and adolescents. Despite its importance, there is limited evidence on the most effective methods to conduct HRRS. However, the literature identifies several key challenges for relevant stakeholders (i.e., youth, parents, teachers, school principals, school authorities, and researchers) that hinder the successful execution of HRRS, as outlined in Table 1 [2, 5, 26–30].

Addressing these challenges requires a coordinated effort among all stakeholders, aligned with public engagement. Public engagement refers to actively and continuously involving the public and relevant stakeholders in scientific research [31]. To ensure the successful implementation of HRRS, clear communication strategies, simplified administrative processes, standardized guidelines, adequate resource allocation, and effective incentives must be established.

Between January and March 2024, we conducted a rapid literature review and five semi-structured interviews with HRRS experts (each approximately 90 min), focusing on four central themes: implementation, facilitators, challenges, and experiences related to HRRS. Building on these findings, we organized a full-day stakeholder dialogue in May 2024, involving 13 representatives from various groups, including youth, parents, teachers, school principals, school authorities, and researchers. The dialogue served to expand the discussion of the four central themes mentioned above while gathering stakeholders’ perspectives. Drawing from the synthesized insights, this policy brief identified three main areas for targeted policy options aimed at effectively conducting HRRS. These areas are recruitment and motivation, retention and incentives, and partnerships and collaboration, and can be assigned within a study timeline as follows (Figure 1):

• Recruitment and motivation: This area mainly encompasses the period from the study’s initiation to the school’s decision to participate.

The policy options within these main areas are designed to complement each other, allowing for simultaneous or sequential implementation. However, it should be acknowledged that our proposed policy options are not exhaustive and may not fully address all challenges associated with HRRS.

This policy brief is primarily targeted at individuals directly involved in the planning and execution of HRRS. These include students, parents, teachers, school principals, school authorities, and researchers – key stakeholders who are well-positioned to implement these options at the local level. Many of these suggestions do not require large-scale political shifts or national-level policy changes but can be directly applied in schools and research settings, emphasizing their practical applicability and potential for immediate impact.

HRRS is essential, as schools provide a unique environment for investigating the health of children and adolescents. Not only do schools allow for the identification of current health issues, but they also provide an opportunity to develop and assess preventive and interventional measures. However, conducting HRRS involves certain challenges. In this policy brief, we highlighted key challenges and offered targeted options in three main areas – recruitment and motivation, incentives and retention, and partnerships and collaboration. While our focus is primarily on Switzerland, these insights and options may also be relevant to other countries. By implementing these option, we can improve HRRS, ultimately contributing to the long-term health and well-being of future generations.

The original policy brief is available in German on the Swiss Learning Health System website (https://www.slhs.ch/en/policy-briefs-stakeholder-dialogues/our-topics/health-related-studies-in-schools-a-unique-opportunity/), along with the summary of the stakeholder dialogue, which took place on 21 May 2024, when 13 stakeholders representing youth, parents, teachers, school principals, school authorities and researchers discussed the policy brief. Subsequently, the policy brief was adapted according to the results of the stakeholder dialogue.