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A New Paradigm for Health Promotion:

An Exercise-Based Approach to Health Enhancement

By: China Technical and Vocational Education and Training (TVET) Innovation Teams

Presenter: Mr. Chenhua Huang

Associate Professor, PhD

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Contents

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Global Health Challenges and New Paradigms

The Evolution of Health Promotion Theory

Three-dimensional Skill Model for Promoting Health through Physical Activity

Physical Activity Contexts and Integrated Practice

Big Data Technology and Intelligent Prescription

China Solutions of the "Institute of Health Promotion with Advanced Technologies "

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Non-communicable diseases (NCDs) and overlapping risks – Chronic diseases now dominate global mortality, interacting with ageing, youth mental health and occupational risks (WHO, 2014; Schmidt et al., 2016; Wu & Fu, 2019; WHO, 2023；Li & Song, 2025; Wang et al., 2025).
Limits of disease-centered models – Treating illness after it appears is no longer sufficient for long-term NCD management and functional decline (Schmidt et al., 2016).
Health promotion as life-course governance – Under the Healthy China strategy and SDGs, health promotion is reframed as life-course, population-wide health governance rather than a marginal add-on (Wang, 2019; Dong et al., 2025).
From behavior to system – Recent work stresses that health promotion must link individual behavior, social environments and institutions to advance equity and sustainable development (Wu & Fu, 2019; Li & Song, 2025).

Global Health Challenges: From Disease Treatment to Health Promotion

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Global Challenges & New Paradigm

Globally, chronic non-communicable diseases have become the leading cause of death, often presenting as multiple coexisting conditions. Scholars including Schmidt, Wu, Fu, Li, Song, and Wang's team have highlighted that chronic disease prevention represents a core ethical issue linking individual responsibility with institutional support.

Concurrently, population ageing, adolescent mental health challenges, and occupational health risks are forming complex clusters of risk.

The traditional disease-centric model—intervening only after onset—has proven flawed. This approach struggles to achieve long-term control, inflates healthcare costs, and exacerbates health inequalities—particularly where prevention and early intervention are weak. Consequently, Healthy China and the Sustainable Development Goals have repositioned health promotion as a governance system spanning the entire lifespan and encompassing all populations, integrating three dimensions: prevention, early intervention, and functional maintenance.

This new paradigm demands the integration of behavioral change, environmental reshaping, and systemic governance, rather than relying solely on individual effort. Today, I shall demonstrate that physical activity serves as a potent tool that bridges these three dimensions.

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Health promotion at the front of the continuum – WHO places health promotion before prevention, treatment and rehabilitation, making it the first line of defense (WHO, 1986; Wang, 2019).
Personal skills as a policy–behavior bridge – “Developing personal skills” links macro-policies to everyday practices through multi-layered health-related competences (Gaspar et al., 2018; Liu & Cheng, 2021; Huang & Xue, 2020).
Physical activity as a core pathway – “Exercise is Medicine” evidence shows PA improves metabolic, mental and functional outcomes across populations (Morales-Palomo et al., 2021; Luo et al., 2016).
From participation to capacity-building – Physical activity is not only participation, but a medium for building health capacities and preventing disease upstream (Nomikos et al., 2016; Qing & Zhou, 2023; Yin et al., 2023).

WHO Health Promotion Continuum and the Role of Physical Activity

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Global Challenges & New Paradigm

The World Health Organization proposes a health continuum framework: health promotion, prevention, treatment, and rehabilitation—with health promotion taking precedence. Scholars note that within the ‘Healthy China’ framework, inadequate health promotion efforts will impose a heavy burden on subsequent prevention, treatment, and rehabilitation work.

The Ottawa Charter emphasizes the development of individual capabilities as a key action area. Research indicates these capabilities encompass health-related life skills, caregiving abilities, and health or rehabilitation professional competencies. Only when individuals can apply these competencies in daily life can policies and environments truly take effect.

Physical activity plays an important role here. The ‘Exercise is Medicine’ initiative and research by scholars confirm that exercise improves metabolic control, mental health, and functional capacity—evidence-based interventions that can be prescribed, monitored, and adjusted.

Scholars emphasize that physical activity transcends mere “exercise participation”, instead building health competencies through short bursts of high-intensity activity and daily integrated movement. Viewed through the WHO continuum lens, positioning physical activity at the core of personal skill development advances health promotion efforts upstream, transforming “active living” into a structured, quantifiable strategy.

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Stage 1 – Education + environments – Early health promotion centered on health education and supportive environments (Ottawa Charter) (WHO, 1986; Zhang, 1998).
Stage 2 – Socio-ecological and social determinants – Ecological models and social determinants frameworks expanded the focus to multi-level systems (McLeroy et al., 1988; Commission on Social Determinants of Health, 2008).
Stage 3 – Molecular mechanisms and digital health – New work links lifestyle interventions to molecular pathways and uses digital tools (VR, mobile health, AI) for scalable interventions (Pall & Levine, 2015; Yadav et al., 2016; Hsieh & Lee, 2018; Sallam, 2023).
Overall trend – Multi-dimensional integration – Health promotion is moving from single behavior models toward integrated frameworks combining behavior, environment, biology and technology (Heard et al., 2020; You et al., 2023; Yin et al., 2023).

The Multi-Stage Evolution of Health Promotion Theory

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Theoretical Evolution

Health promotion theory has evolved through three key phases, a framework that positions physical activity initiatives.

Phase 1, guided by the Ottawa Charter, focused on empowering individuals via health education and supportive environments. Chinese scholars applied this to maternal-child and school health, integrating education and environmental interventions.

Phase 2, shaped by the socio-ecological model and social determinants of health, expanded from individual behaviors to multi-level change—covering individual, interpersonal, organizational, community and policy levels—addressing health inequalities from socio-economic structures.

Phase 3, adds molecular mechanisms and digital health. It explains how lifestyle interventions work, and uses VR and AR, mobile health apps and large language models for large-scale, personalized health support. These technologies improve information quality but also raise ethical questions, as noted by scholars like Hsieh.

Overall, health promotion shifts from cognitive focused to an integrated approach (behavior, environment, biology, technology. Chinese research by Yu and Yin, such as "Exercise is Medicine" and the integration of physical education with digital platforms, localizes this idea. This integrated perspective is the theoretical foundation for the physical activity-based health promotion paradigm I will elaborate on next.

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Physical activity is no longer just sport or fitness, but a core medium of health promotion.
Biologically: It improves body structure, function, and metabolism, reducing all-cause mortality and NCD risk.
Psychosocially: It enhances social participation and resilience, improving mood and life satisfaction.
Physical activity sits at the intersection of bio-psycho-social models and is a key entry point for the new paradigm.

From “Physical Activity” to “Physical-Activity-Based Health Promotion”

Reframing

PA as health promotion

Physical-Activity-Based

Health Promotion

Health capacity focus
Bio-psycho-social benefits
Multi-setting
Life-course

Traditional

“Sport/Exercise”

Performance focus
Fitness or competition
Often limited to "sports settings"

Biological

Social

Psychological

Physical

Activity

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Theoretical Evolution

Against this backdrop, physical activity is no longer merely “sport” or “fitness”; it has become a core medium for promoting health.

Biologically speaking, it improves bodily structure and function—including cardiovascular and muscular systems, metabolism, and immune responses—thereby reducing all-cause mortality and the risk of major chronic diseases.

At the psychosocial level, it promotes social participation, enhances resilience, and assists individuals in coping with stress and emotional difficulties.

Group exercise, community walks, and campus sport activities yield both social benefits and psychological advantages.

Thus, physical activity occupies a central position within the biopsychosocial model of health, forming a vital nexus between the physical, psychological and environmental dimensions. Precisely for this reason, I regard health promotion grounded in physical activity as a crucial breakthrough point for the new paradigm.

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WHO identifies “developing personal skills” as a core action area in health promotion.
Policies and environments must ultimately be translated into executable behaviors and skills.
From a physical activity perspective, personal skills should encompass lifestyle, fitness, and self-management.
Hence a three-dimensional, physical-activity-based health promotion skills model is proposed.

WHO Action Area: Interpreting “Developing Personal Skills” Through Physical Activity

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3D Skills Model

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Dimension 1: Lifestyle and Risk Management Skills

Healthy diet and weight control: knowing what to eat, how to eat, and how much to eat.
Sleep, sedentary behavior, and stress management via daily activity and light-to-moderate exercise.
Basic movement safety: correct posture and load control in sitting, standing, walking, and lifting.
Risk recognition: e.g., helping older adults avoid inappropriate high-intensity exercise.

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3D Skills Model

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Dimension 2: Whole-Body Functional Fitness Skills

Planned exercise training to improve cardiorespiratory endurance, muscular strength, and endurance.
Enhancing flexibility, balance, coordination, and agility as key fitness components.
Optimizing biomechanical patterns to reduce injury risk and improve efficiency.
Supporting high-quality functioning in work, study, and daily life.

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3D Skills Model

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Dimension 3: Health Literacy and Self-Management Skills

Understanding basic exercise prescription principles: frequency, intensity, time, and type (FITT).
Recognizing fatigue, pain, and warning signs to adjust exercise loads in time.
Setting goals, monitoring progress, and using self-feedback to build long-term habits.
Proactively adapting exercise goals and content across different life stages.

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3D Skills Model

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Children and adolescents: school PE plus extracurricular activity to improve fitness and psychosocial development.
Older adults: balance, strength, and aerobic training to delay functional decline and reduce falls.
People with chronic conditions: individualized exercise prescriptions integrated with clinical care.
Working populations: workplace exercise and active breaks to counter sedentary lifestyles and work stress.

Physical Activity Strategies for Priority Populations

Multi-Setting Layout for Physical-Activity-Based Health Promotion

Schools: health-promoting schools and PE reform to build a culture of “moving well and moving more.”
Communities: walking paths, public squares, and gyms to provide accessible activity spaces.
Workplaces: active breaks, standing desks, and incentive programs for activity.
Clinics and rehab centers: integrating “exercise is medicine” into standard care pathways.
Camps and wellness tourism: integrating physical activity, nutrition, and psychosocial support.

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Integrated Practice

Applying this model requires designing targeted strategies for key groups.

For children and adolescents, school physical education and after-school activities build fitness, movement skills and psychosocial abilities like confidence. For older adults, combined balance, strength and aerobic training delays functional decline and supports independence. For those with chronic conditions or high risk, personalized exercise prescriptions (linked to medical care) act as key non-pharmacological treatment, slowing disease progression. For the working population, workplace activities and active breaks reduce sedentary time and stress.

Across all groups, activities must be tailored to individual needs, risks and environments—while keeping health promotion’s core logic consistent. We also need to focus on daily settings: health-promoting schools, communities with sports facilities, workplaces or clinics integrating “exercise is medicine,” and activity-nutrition-psychology combined camps. These together create an activity-friendly health ecosystem.

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Assessment dimensions: body composition, physiological function, fitness, and habitual activity levels.
Tools: lab-based tests, field fitness tests, and wearable devices.
Standardized data collection: unified protocols, recording formats, and quality control.
Providing reliable data foundations for big data modelling and intelligent prescriptions.

Standardized Physical Activity and Fitness Assessment System

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Smart Prescription

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Using large-scale data to build population-specific activity profiles and risk stratification.
Developing models and algorithms to match exercise programs to individual assessment results.
Continuously monitoring and dynamically adjusting intensity and content during implementation.
Enabling frontline staff with limited experience to deliver high-quality, relatively precise prescriptions.
Feeding new data back into models so that the system becomes “smarter with use.”

Big Data and AI: Generating and Optimizing Smart Exercise Prescriptions

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Smart Prescription

Leveraging high-quality data, big data and artificial intelligence can facilitate smarter health promotion.

Through data aggregation, we can construct population activity and physical capability profiles, revealing typical patterns and risk distributions.

Based on assessment outcomes, health status, and goal setting, we can develop exercise program models and algorithms tailored to individual needs, generating personalized training plans.

During implementation, continuous monitoring via assessments, wearable devices or follow-ups enables dynamic adjustments to exercise intensity, training volume and type.

This empowers frontline staff with limited experience to issue precise, safe prescriptions with system support. As data accumulates and models continually optimize, the system will grow increasingly “intelligent” through practical application.

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Platform function: a hub integrating education, research, technology, and industry.
Theoretical basis: the three-dimensional, physical-activity-based health skills model.
Educational form: joint programs and co-designed curricula across countries and institutions.
Role: both a talent training base and a testbed for technological and policy innovation.

Overall Vision of the “Institute of Health Promotion with Advanced Technologies”

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China Solution & Institute

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Curriculum Framework: Developed across three skill dimensions, encompassing clusters of program at foundation, undergraduate and postgraduate levels.
Competence standards: creating evaluable and mutually recognizable health promotion skill standards.
Data platform: building an open activity and fitness data platform based on existing national monitoring systems.
Technical outputs: providing unified assessment and decision-support tools for schools, communities, enterprises, and governments.

Curricula, Standards, and Data Platforms: A Physical-Activity-Based China Solution

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China Solution & Institute

Within this framework, there are three key components.

Curriculum System: Based on the three-dimensional model, we shall jointly design coherent curricula and practical modules spanning specialized diploma, undergraduate and postgraduate levels, cultivating students' ability to design, implement and evaluate physical activity-based program.

Competency Standards: We have established clear, measurable standards for promoting health through physical activity, ensuring these standards are assessable and, ideally, mutually recognized across different institutions and nations.

Data Platform: Leveraging the Physical Fitness Monitoring platforms, we have established an open activity and physical fitness data repository. This provides assessment, research, and decision-making support for schools, communities, enterprises, and government bodies.

Collectively, these elements constitute a physical activity-based health promotion solution grounded in Chinese practice, possessing potential for international dissemination and collaboration.

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Education: training multidisciplinary professionals with core competencies in physical-activity-based health promotion.
Research: conducting intervention and evaluation studies in key populations and settings.
Industry: co-creating a health promotion ecosystem with nutrition, sports equipment, and wellness tourism sectors.
International: co-developing curricula, sharing data, and launching joint projects with ASEAN and other regions.

Education–Research–Industry Synergy and International Collaboration

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China Solution & Institute

The institution must genuinely achieve deep integration of education, research and industry, while actively pursuing international collaboration.

In the educational sphere, we cultivate interdisciplinary professionals – integrating knowledge systems from physical activity, health sciences, behavioral sciences and data technology.

At the research level, we conduct intervention and evaluation studies targeting key populations and scenarios to generate evidence-based grounds for effective interventions, including suitable populations and implementation conditions.

At the industrial level, we collaborate with sectors including nutrition, sports equipment, digital health, and health tourism to jointly develop services and products supporting physical activity promotion.

Internationally, we partner with ASEAN and global collaborators to develop joint curricula, shared data initiatives, and collaborative program. Through comparative models and adapted strategies, we build a global learning network centered on physical activity promotion.

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From disease-centered to capacity-centered, with physical activity as a key tool for building capacity.
From isolated interventions to integrated layouts across populations, settings, and technologies.
From experience-driven to evidence- and data-driven intelligent decision-making.

Summary: Three Key Shifts in the New Paradigm of Health Promotion

Outlook: Making Evidence-Based Physical Activity the New Normal for Public Health

Using platforms such as the Future Institute of Health Promotion Technologies to drive theory and policy implementation.
Building long-term collaboration networks across sectors, disciplines, and countries around physical activity.
Enabling more people to “move more, move wisely, and move for life,” truly shifting health promotion before disease.
Jointly contributing a new paradigm and a China solution for physical-activity-based health promotion in a healthy society.

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Today’s talk centers on three key shifts defining a new physical activity-based health promotion paradigm.

From disease-centered to capacity-centered: Lifelong health capacity building, with physical activity as core tool.

From isolated interventions to integrated layouts: Cross-population, cross-setting, cross-technology; embed physical activity into a broad ecosystem.

From experience-driven to evidence or data-driven: Use standardized assessments, big data and AI for precise, scalable, equitable health promotion.

Looking ahead, platforms such as the Institute of Health Promotion with Advanced Technologies can serve as catalysts for this paradigm shift, seamlessly integrating theory with practice and innovation with policy.

We anticipate sustained collaboration among nations across sectors including health, education, science and technology, and industry, as well as across different regions, centered on health promotion grounded in physical activity.

Our objective is straightforward yet ambitious: to empower more people to engage in physical activity, to do so more scientifically, and to maintain this practice throughout their lives. When physical activity becomes a natural, evidence-based component of daily living, health promotion truly achieves prevention through proactive measures.

Let us join hands to contribute new paradigms and localized solutions for health promotion grounded in physical activity, collectively advancing towards a future where health is shared by all.

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Contact us: China Technical and Vocational Education and Training (TVET) Innovation Teams �Email:huangchenhua280@gmail.com/ 262648504@qq.com

Thank you very much for your attention!