Promoting Mental Health, Physical Activity, and Healthy and Sustainable Dietary Behavior Among Practical Education Students in the Netherlands: Protocol for a Multiphase Participatory Research Study.

The study targets practical education (praktijkonderwijs) students, a youth group in vulnerable positions who are underrepresented in participatory research and health promotion programs.

• Most youth health promotion programs target the general adolescent population without addressing underlying equity issues.
• Participatory research, described as 'a promising methodology for the development of health promotion programs and addressing health equity,' leaves youth in more vulnerable positions often underrepresented.
• The research is part of the LIFTS (Healthy Lifestyle for Low-Literate Teenagers) project.
• The project focuses on promoting mental health, physical activity, and healthy and sustainable dietary behavior.

The research protocol has two primary objectives: gaining insight into how to meaningfully involve youth in vulnerable positions in participatory research, and gaining insight into possible outputs and outcomes of the developed health promotion programs.

• Objective 1 focuses on practical education students as a case study for participatory research engagement.
• Objective 2 focuses on possible outputs and outcomes of the developed health promotion programs.
• The research uses a multiphase mixed methods research design consisting of 3 studies.
• Research methods were developed in collaboration with practical education schools and relevant LIFTS stakeholders.

The protocol includes a systematic literature review (Study 1) examining empowering approaches to engage practical education students and similar youth as coresearchers in health promotion program design and implementation.

• The protocol for the systematic literature review was ready and submitted to PROSPERO on April 11, 2025.
• The review examines current knowledge on engaging practical education students and 'similar youth groups as coresearchers in health promotion program design and implementation.'
• This study addresses the first research objective regarding meaningful youth involvement in participatory research.

An empirical qualitative study (Study 2) was conducted at practical education schools to explore if and how students can meaningfully be engaged as coresearchers in participatory research for health promotion program design.

• Data collection and analysis of the empirical qualitative study were finished in September 2025.
• The study explores if and how practical education students can meaningfully be engaged as coresearchers.
• Results were written following completion of data collection and analysis in September 2025.
• This study also addresses the first research objective.

A realist evaluation (Study 3) of the newly designed health promotion programs within LIFTS is planned to address the second research objective regarding program outputs and outcomes.

• The realist evaluation is foreseen for 2026.
• It will evaluate the newly designed health promotion programs developed through the participatory research process.
• This study addresses the second objective of gaining insight into possible outputs and outcomes of the developed programs.

The research is expected to deliver practical recommendations and lessons learned on actualizing youth empowerment in participatory research for health promotion, as well as contribute to health equity in the Netherlands.

• The researchers expect to 'deliver practical recommendations and lessons learned on how to actualize youth empowerment in participatory research for health promotion, which may inspire future researchers.'
• The project seeks to 'promote health equity in the Netherlands by contributing to the development and implementation of tailored health promotion programs for practical education students.'
• The research also aims to contribute to advancement of academic knowledge in health promotion and participatory research with youth in vulnerable positions.