Participatory health research and promotion with children in Germany: a scoping review.

backgroundParticipatory health research and promotion (PHR/P) emphasizes collaborative knowledge production, mutual learning, and redistribution of power between academic and non-academic actors. With children, PHR/P has gained increasing legitimacy under the United Nations Convention on the Rights of the Child, which recognizes children as rights-holders and social actors. However, little is known about how PHR/P with children is framed and enacted in Germany. This review provides the first systematic overview of PHR/P with children in Germany.

methodsWe conducted a scoping review following Arksey and O'Malley's framework and PRISMA guidelines. Searches were performed in four databases in March-April 2024, supplemented by snowballing of friends' studies. Eligible studies (2000-2024) reported empirical projects in Germany (plus two projects from German-speaking Switzerland) that explicitly applied participatory approaches with children (< 18 years) and addressed health-related topics. Medical intervention studies and studies limited to clinical patient groups were excluded. Data extraction used a structured codebook adapted from the International Collaboration for Participatory Health Research and focusing on objectives, actors, research phases, and reflections. Two reviewers coded each report independently.

resultsTwelve projects (23 publications) met the inclusion criteria. Most projects were situated in educational or communal contexts. Health-related objectives were consistently reported, often focusing on behavioural change. Participatory objectives were less frequent, remained implicit in several cases, and were rarely defined with children. Children typically participated alongside other adults, rarely as the sole group of non-academic actors. Participation was usually reported in operational phases (e.g. data collection), whereas involvement in conceptual phases (e.g. defining research questions, analysis, dissemination) was uncommon. Creative methods (e.g. photovoice, theater, drawing) were widely used. Reflections focused mainly on ethics, informed consent, and child protection, while sustainability, power relations, and children's perceived benefits were seldom addressed. Reporting practices were often vague, limiting systematic assessment. DISCUSSION: PHR/P with children in Germany has gained traction but remains unevenly reported. Health-related goals dominate participatory aims, children's roles are often mediated by adults, and reflections on sustainability and power remain underdeveloped. Greater transparency in reporting participatory processes is essential to strengthen cumulative knowledge and design meaningful child-centred approaches. Trial registration N/A.