Mahomed, Ruzaika ShaikEtokabeka, Elsa2025-05-062025-05-062025-02Shaik Mahomed, R., & Etokabeka, E. (2025). Health promotion intervention in at-risk South African primary schools. Health Education Journal, 84(1), 22-32. https://doi.org/10.1177/00178969241289331.0017-8969 (print)1748-8176 (online)10.1177/00178969241289331http://hdl.handle.net/2263/102298Please note that Dr Karien Botha's name was removed from this submission on request. Although it features in the post-print, it was later removed from the final online and print publications.BACKGROUND : Interventions to promote health have been implemented in some urban settings. However, school-based health promotion interventions in at-risk urban schools have not been thoroughly investigated. OBJECTIVE : This article investigates teachers’ perceptions regarding health promotion interventions with the main goal of establishing social change in at-risk school communities. DESIGN : The study used phenomenology as a theoretical lens supported by the use of a qualitative research approach. As a theoretical framework, the researchers utilised Vygotsky’s sociocultural theory. SETTING : The investigation used a descriptive case study design to select 17 teachers from 2 at-risk urban primary schools in Pretoria. METHODS : Visual data including participatory reflection action posters and photographs, and field notes were part of the data collection techniques. FINDINGS : Teachers’ responses informed how school-based health promotion interventions can be developed in the foundation phase of education. Themes relevant to this included recognition of the importance of education in bringing about social change; involving the whole community in developing health promotion projects; working closely with parents; promoting physical activity; and advocating for nutritional literacy. Goals can best be achieved through a focus on nutritional needs, physical health and social needs of at-risk communities. CONCLUSION : Findings from this study can be used to inform at-risk communities about food consumption, optimum physical activities and positive socio-emotional actions. Beyond this, young professionals entering the field of education should be encouraged to develop awareness of how school-based health promotion programmes can benefit the health and well-being of children.en© The Author(s) 2024.At-risk schoolsHealth promotionNutritional educationPhysical activitiesSchool-based health promotion interventionPreprint Article