Future, Volume 4, Issue 1 (March 2026) – 11 articles

The Daily Move (TDMo) is a modified version of The Daily Mile, a primary school-based physical activity initiative, that provides children greater choice in activities during participation. This study evaluated a teacher-led implementation of TDMo, aiming to assess its sustainability within primary schools. Teachers (N = 60) implemented TDMo with their classes for two 5-week blocks across two school semesters. Data were collected via questionnaires administered at the start and end of each block (Time 1 to Time 4), aligned with the RE-AIM framework’s effectiveness, adoption, implementation, and maintenance elements. Two teacher focus groups (n = 6) and one child focus group (aged 8–9 years; n = 6) were conducted at Time 4. The findings presented in this paper are based only on participants who provided complete questionnaire data at all four timepoints (n = 28). TDMo was perceived to positively impact multiple health metrics across timepoints, including physical fitness (agreement decreased from 92 to 84%), movement proficiency (agreement increased from 84.6 to 96.2%), and attention and concentration (agreement decreased from 96.2 to 92.3%). Teachers reported all children responded positively to its adoption (100%). Children’s involvement in game selection increased significantly from Block One to Block Two (p = 0.01). The main implementation barriers were curriculum demands (agreement decreased from 80 to 72%) and inclement weather (agreement increased from 50% to 53.8%). Most teachers intended to sustain their implementation of TDMo (96.2%). The diverse and novel design of TDMo offers potential holistic health benefits and supports long-term sustainability. The variety of physical activity appears to enhance children’s enjoyment and encourage teachers’ sustained implementation. Recognition of these benefits by teachers and school staff, and their commitment to incorporating movement breaks within a typical school day, may further support sustainability. Full article

Background: Children with Attention Deficit Hyperactivity Disorder (ADHD) often face behavioral challenges, which may be exacerbated through bidirectional parent–child interactions. Sex differences and cultural context may further shape this pathway. This study aims to examine these relationships among children’s ADHD symptoms, behavioral problems, and parental emotions (anxiety and depression) within China, testing whether parental emotions serve as a mediator and exploring potential differences across child sex. Methods: A path analysis was conducted among children’s ADHD symptoms, children’s behavioral problems, and parental emotional symptoms. Children’s ADHD symptoms were measured using the Swanson, Nolan, and Pelham version IV scale-parent form (SNAP-IV), while the Strengths and Difficulties Questionnaire (SDQ) assessed behavioral problems. Parental emotional symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales. All questionnaires are in Chinese. Results: The direct, indirect, and total associations of children’s ADHD symptoms on behavioral problems were significant in all models. In the full model, the indirect association, defined through parental emotional symptoms, was estimated at 0.206 (95% CI: 0.157–0.262). The indirect pathway constituted 27.3% of the total association. Conclusions: Parental emotional symptoms are associated with both children’s ADHD symptoms and their behavioral problems, indicating a potential pathway warranting further investigation. Child sex does not play a significant moderating role in the path, but an indirect association from ADHD symptoms to peer problems is observed in boys, not girls. Full article

The development of health literacy skills yields numerous benefits, including reduced premature mortality, better engagement with preventative health services (e.g., immunisations and screening) and medication compliance. Schools are an ideal setting to promote health education. The Personal, Social, Health, and Economic curriculum is essential in equipping children for adulthood, addressing health, relationships, and well-being. In recent years, commendable emphasis has been placed on mental health, healthy relationships, substance use, healthy weight, and physical activity. However, education concerning physical health, including immunisation, within the context of health literacy has not been prioritised. This Viewpoint piece examines several contemporary issues within the realm of health education, including contributions from those with lived experience, and proposes recommendations to complement broader health improvement models. Full article

Recent collective stressful events have influenced adolescents’ perceptions of the future; however, their impact on future-thinking and the coping strategies used to manage these challenges remain unclear. This study examines adolescents’ future-related concerns in response to collective stressful events and the strategies they adopt to cope with them. In spring 2024, 12 focus groups were conducted with 97 high school students (46.4% females; Mage = 15.34; SDage = 1.06) in Italy. Participants discussed experienced collective stressful events, their main concerns about the future, and related coping strategies. Data were analyzed using thematic analysis. Students identified four major events: war, climate change, economic crisis, and the COVID-19 pandemic. These events triggered concerns such as ‘uncertainty about future plans and goals,’ ‘limitations on personal freedom,’ ‘deteriorating survival conditions,’ ‘the outbreak of sudden events and natural disasters,’ and ‘job loss and increase in prices.’ Five coping strategies emerged: ‘taking action,’ ‘staying informed,’ ‘avoiding overthinking,’ ‘seeking social support (from family, friends, and teachers),’ and ‘seeking support from institutions.’ Findings highlight adolescents’ future-related concerns and underscore the need for interventions promoting adaptive future-oriented thinking. Full article

Schoolbags represent a common source of physical strain for school-aged children and may influence posture during critical years of growth. This systematic review synthesizes evidence published since the previous review (1995–2014), which mainly focused on load thresholds and did not consider postural health as a multidimensional outcome. The review protocol was prospectively registered in PROSPERO (CRD420251080328). PubMed, Web of Science, and Google Scholar were systematically searched up to 11 June 2024. Of 1013 screened articles, 12 studies met the inclusion criteria. Schoolbag weight was the most frequently investigated factor, followed by postural and spinal alterations, particularly scoliosis. Excessive loads were consistently associated with trunk inclination, postural asymmetry, lumbar strain, and musculoskeletal discomfort. Several studies reported demographic differences, with girls showing greater susceptibility to postural deviations and boys carrying heavier loads. Compared with earlier evidence, more recent studies employed improved postural assessment methods and broader outcome frameworks incorporating ergonomic and behavioral factors. Despite methodological heterogeneity, findings support limiting schoolbag weight to 10–15% of body weight. This review highlights the importance of integrating ergonomic design, carrying behaviors, and demographic modifiers into school health guidelines and provides practical recommendations for clinicians, educators, and policymakers. Full article

Families with low income are faced with various intertwined public health issues, including low literacy levels and nutrition insecurity. Although numerous studies have detailed effective methodologies for delivering literacy or nutrition education in silos, there is no protocol for developing, implementing, and evaluating a brief, interdisciplinary literacy and nutrition education program for parent–child dyads. Books & Cooks, a seven-week literacy and nutrition education program aimed at improving families’ literacy and nutrition capacities by providing parents with strategies to assist their child, facilitating interactive education lessons, and providing take-home reflection activities, was piloted during the 2023–2024 school year. Results informed the protocol for current and future cohorts in efforts to further enhance outcomes. Family literacy capacity is addressed using evidence-based, grade-appropriate literacy techniques and evaluated using validated and internally developed instruments. Family nutrition capacity is addressed through education and cooking lessons based on the 2020–2025 Dietary Guidelines and MyPlate and evaluated using validated instruments. Results will be analyzed by assessing change from baseline to post-program completion, addressing potential confounding factors, and utilizing randomization. By detailing the development, implementation, and evaluation of this study, we anticipate that this protocol will provide guidance for cross-functional collaborators who seek to address various public health concerns in at-risk populations. Full article

Pain in children and adolescents remains an underestimated and undertreated condition, with long-term physical and psychosocial consequences. Non-invasive neuromodulation has emerged as a promising, low-risk approach for managing acute and chronic pain by modulating central and peripheral neural pathways. This systematic review followed PRISMA 2020 guidelines to evaluate the efficacy, safety, and clinical applicability of non-invasive neuromodulation techniques in pediatric pain. Searches were conducted in PubMed, Embase, Scopus, Web of Science, Cochrane CENTRAL, and ScienceDirect for randomized controlled trials (RCTs) published between 2015 and 2025. Six RCTs met the inclusion criteria, encompassing percutaneous electrical nerve field stimulation (PENFS), transcutaneous auricular vagus nerve stimulation (taVNS), transcutaneous electrical acupoint stimulation (TEAS), and transcutaneous electrical nerve stimulation (TENS). Four trials reported significant reductions in pain intensity alongside improvements in functional outcomes and quality of life, particularly in functional abdominal pain and postoperative contexts. Most studies showed low or moderate risk across domains, with appropriate randomization and blinded assessment. No serious adverse events were reported, confirming an excellent safety profile. These findings support non-invasive neuromodulation as a feasible and well-tolerated adjunct to conventional pediatric pain management. Further high-quality trials are warranted to standardize protocols and explore mechanisms of neuroplasticity in the developing nervous system. PROSPERO (CRD420251170866). Full article

Children with special health care needs require health and related services beyond those required by children in general, which may affect their participation and inclusion in school. School nurses play a key role in supporting these children through a range of health-related interventions within the school setting. However, evidence on school nurse–led interventions for this population remains fragmented. This scoping review will follow the JBI methodology and aims to map the nature and extent of interventions developed by school nurses for children with special health care needs in school settings worldwide. The review will provide an overview of current practices and may inform the development of school health policies and evidence-informed nursing interventions. This research is registered on the Open Science Framework platform since 10 June 2024, with data updated on 26 August 2025. Full article

Adolescence is a critical life period connected with the initiation of substance use. Exploring the prevalence of and contributors to adolescents’ smoking, drinking, and drug use is essential for developing effective health education programs. This study aims to detect prevalence rates of adolescent substance use and their association with sociodemographics and a set of psychological, social, and school-related variables. Participants were high school students (9th graders, N = 1590; 694 males, 896 females) in Békés county, Hungary. The lifetime prevalence rates were the following: smoking (47.2%), alternative smoking (49.2%), drinking (85.7%), cannabis use (7.6%), sedative use (7.0%), and designer drug (herbal) use (3.7%), with gender differences (a surplus of girls) found only in smoking and sedative use. Using bivariate logistic regression analyses, depressive and psychosomatic symptoms and internet addiction increased the odds of all types of substance use, life satisfaction, future orientation, and social support from the family, while school achievement and school satisfaction showed odds-reducing effects. In multivariate analyses, the various types of substance use were predicted by different variables, while psychosomatic symptoms, social support from the family, and school achievement seemed to be the most relevant contributors. Health education programs should also incorporate fostering mental health to prevent adolescent substance use. Full article

While perfectionism is recognized as a complex personality trait with both adaptive and maladaptive facets in adults, the specific developmental and contextual factors that influence its emergence in children are poorly understood. This study addresses this critical gap by examining associations between children’s perceptions of family climate and emotion regulation strategies. A sample of 191 children (94 boys, M_age = 11.27 years, SD = 0.97) completed standardized measures of perfectionism, family environment, and emotion regulation. Results indicated that both family climate and emotion regulation significantly predict perfectionism in children (R² = 0.36). Specifically, children’s perceptions of high parental control, a strong achievement family orientation, and reliance on expressive suppression (hiding emotions) emerged as moderate, significant predictors. These findings clarify the developmental factors underlying perfectionism, providing actionable targets—particularly around adaptive parenting and emotion coping—for child and family support programs and preventative interventions focused on promoting long-term well-being. Full article

Food allergies in school-aged children are a growing public health concern, requiring coordinated strategies to ensure safety in educational settings. This study aimed to evaluate the safety conditions for children and young people with food allergies in public schools of the municipality of Matosinhos, Portugal. A descriptive, cross-sectional, quantitative study was conducted during the 2022/2023 academic year, targeting coordinating teachers from all public schools. Data were collected using a structured questionnaire based on national guidelines for managing food allergies in schools. Results revealed significant gaps in preparedness: 35.99% of respondents reported the absence of a formal document on food allergies, 66.01% indicated no school training plan on the topic, and bar and canteen staff were often excluded from training (50.00% and 42.00%, respectively). Furthermore, 83.02% stated that preventive measures were not consistently adopted, and 49.99% felt insufficiently trained to act in emergencies. Based on these findings, an intervention project with tailored training sessions for coordinating teachers was proposed to improve safety and inclusion for students with food allergies. The study highlights the urgent need for standardized protocols, inclusive training, and preventive measures in schools to mitigate risks and foster a safe learning environment for children with food allergies. Full article