We will not mince our words: the terms “education” and “health” do not go hand in hand so easily. Their proximity deserves to be constantly questioned. We owe it to ourselves to always seek to identify what does or does not allow these terms to resonate. Associating the terms “education” and “health” highlights the irrevocable tension between giving way to the person who has the capacity to make decisions, and the temptation to educate “for” a health whose characterization is itself debated in the social sphere.

What can we do? How can we avoid seeking freely given and behaviorist submission? How can we ensure that the subject retains this decision-making position, taking into account their life environment and their own uniqueness? How should we react to the recurring challenges in public health that question the role of the subject in terms of much larger societal problems? These questions are sources of doubt, and doubt contributes to removing what is taken for granted.

The fundamental epistemological posture for health education probably consists of placing the person and groups at the heart of the approach, followed by integrating the weight of living contexts. It is not knowledge that prevails, but what the subject does with it. Knowledge, both heterogeneous and composite, functions such that allows the person to build their own rationality to lead (or not) a possible life. This will be the focus of this book, which endeavors to shed light on a number of points that constantly call into question health education practices.

This book, based on previous work on social health representations and concepts, aims to see how a renewed theorization could allow us to form a link between the subject (in their biological, psychological and social dimensions) and an educational approach that integrates their singularity.

After a decade of work in health education, our reflection therefore falls into a perspective of theorization of one of its constitutive aspects, potentially the most important: that of comprehending and taking into account health concepts.

The author’s thesis work, carried out in 2008, was one of the first to look at health education in the school environment using a psycho-ergonomic view of development within the wider framework of education sciences and activity analysis. Nearly 10 years later, the scientific field of health education has developed. It has even percolated in the scientific sphere, questioning scientific objects with diverse approaches in the fields of public health, sociology, anthropology, psychology, management and, of course, the educational sciences. As proof of this evolution in the university environment, teacher–researcher posts are now dedicated to health education, journals are devoted to it, a scientific network has been reinforced (UNIRéS, university network for health education), symposiums are multiplying and the hexagonal bibliography has expanded, even though it struggles to cover its delay at the international level.

This field of research inherently calls for multidisciplinarity. Although collaborations of this kind are always modest (similar to other fields of research in education), the various insights that current health education benefits from allow a step back to be taken after 10 years, following the appearance of this field of research. While certain people reproached it for not being a “discipline”, we now see that it has “disciples” through the development of an interesting and much more diffuse movement within the scientific community than at its initial appearance. It is almost amusing that this field of research that remained marginal for several years has now found its place, notably in university disciplines where it was not expected nor wanted. However, we will retain from this evolution the positive character generated by this gradual movement of multidisciplinary appropriation. What ensued was the redefinition of the health education profile, even a shift from “education for…” (confined to teaching problems and centered on education science), toward a contrast of the terms “education” and “health” at the crossover of educational and health theoretical foundations. Nevertheless, the juxtaposition of these two terms allows the description of a reciprocity, which also pushes for the consideration of convergences. It is in this perspective that this book’s approach belongs: identifying what will push forward the theorization of a field that is currently scientifically wellestablished, without necessarily focusing on a disciplinary approach which in no way allows for the apprehension of the entire complexity. It is therefore necessary to include psychology, social psychology, sociology, education sciences and, of course, public health.

In order to address what could be considered as “fundamental” in this field of research, several red lines will be unraveled in the following lines. Indeed, putting “education” and “health” into perspective is not neutral, whether from epistemological or epistemic points of view, notably with the integration of public health issues. This questions the role of the subject, on the one hand, and their position within groups or society, on the other hand. Looking at understandings of health places a set of elements in tension. In this process of analysis and theorization, we must therefore fall back on a variety of disciplines to which the frames, models and methodologies refer. By approaching the “health” of “educational” preoccupations, it then quickly becomes necessary to understand from where the author speaks, from where the author questions, observes and collects, then analyzes and discusses. The researcher himself benefits from adopting a posture that allows him to reinterrogate the objects of research that he manipulates. The objectification of methodologies, for collection as well as analysis, becomes a gauge of scientific rigor. Linking “education” and “health” pushes the researcher in his entrenchment, sends him back to his role as a citizen, to what he is himself. Describing these links jostles him in terms of his personal and professional history. He cannot extract himself completely from what he is. It is on this point that human and social sciences lack, it seems, hardness.

But what hardness do we mean? That which distinguishes so-called “soft” sciences from so-called “hard” sciences. Jacques Ardoino (1993) attempted to clarify these aspects: “While this notion (‘soft’) designated, more traditionally, that which remained entangled, still waiting to be ‘unraveled’ through a reduction of elements that are increasingly simple, and increasingly ‘pure’, the modern meaning, enriched by contributions from cybernetics, developed in the context of a systemic approach and not without link to the Lewinian theory of the ‘field’ (borrowed from the physical electromagnetic model), suggests a more ‘molar’, global, indecomposable, grasp. However, at a second, more detailed reading, ‘molar’ could be profitably replaced by ‘holistic’, better characterizing the complexity of human phenomena. Effectively, ‘molar’, from ‘mole’ (gram molecule, molecular mass of a substance), in chemistry, is in opposition to atomics (simple decomposed elements), whereas holistic, derived from holism (general epistemology), designates, in contrast with atomics, a position according to which we cannot understand the parts without knowing the whole. In this perspective, ‘complex’ should be carefully differentiated from ‘complicated’ (the latter notion has the potential to allow the decomposable and irrevocable characteristic of its objects)”.

By thus exposing our posture and research process which has led to the theorization of concepts in health, we once again highlight the entire complexity inherent to our objects, their contexts, the subjects themselves and the researchers who encounter them. Edgar Morin (1977) specifies that “complexity first imposes itself as impossible to simplify; it occurs there where the complex unit produces its appearance, where distinction and clarity become lost, where disorder and uncertainty disturb phenomena, where the subject-observer surprises himself in the object of his observation, where antinomies cause reasoning to diverge… Complexity is not complication. That which is complicated can be reduced to a simple principle such as a tangled coil or a sailor’s knot. Certainly, the world is very complicated, but if it were only complicated, that is to say tangled, multi-dependent, etc., it would only require applying well-known simplifications […]. The real problem therefore is to not relate the complication of developments to rules that have simple bases. Complexity underlies it”. And he adds, “such a confluence of before-then disjointed notions brings us closer to the principal core of complexity which is not only in the linking of the separate/isolated, but the association of what was considered as antagonistic. Complexity corresponds, in this sense, to the irruption of antagonisms at the heart of organized phenomena, to the irruption of paradoxes or contradictions at the heart of a theory. The problem with complex thought is then to think together, without incoherence, two ideas that are, however, contrary”.

Faced with this intrinsic and extrinsic complexity linking “education” and “health”, we will look at several approaches. In other words, we seek to vary the points of view to showcase several sources of insight. This posture comes with great epistemological vigilance in order to avoid “naturalizing” knowledge (Berger, 2007). Multireferentiality is not considered as a research methodology: it remains a posture that guides our research activity (Ardoino, 1993) but must remain prudent. This in the interest of avoiding at all costs the articulation of heterogeneous paradigms (Monjo, 2003) and better understanding some of the overlap, sometimes revelatory of contradictions in the subjects and often difficult to elucidate. It was our object of research that led us to go through a plurality of paradigms (Fortin, 2005) in order to leave the pervasiveness of a medicalized introduction to health behind. To iterate the words of Guy Berger (2007), “everything is relative to position” (“from where I stand, I think that…”). This also brought us to consider our research practice as a social practice comparative to other social practices, carrying, as we will attempt to demonstrate, its own norms and paradigms. We are not, therefore, aiming for a syncretism that would push us to take from everywhere simply to “oblige”. Instead, we rely on the cultural and historical reading of our research object to legitimize this multireferential approach. Thus, a work path is defined, a personal walkway that attempts to state an objective with the help of different sources of insight and engaging only its author.

We are aware that the models we propose can sometimes lead to categorical thinking which then amplifies the differences between categories and minimizes the intercategorical. “Our knowledge does not dispel what we do not know” (Berger, 2007). This allows the definition of the complexity of things by positioning our work at different levels (subject, group, organization, institution) altered by mutual modifications.

This approach arose from the embarrassment in which practitioners always found themselves when they started to rethink their methods, no doubt to optimize them, with a more deliberate praxeological intention, but also to attempt to better understand or even to theorize them, from a perspective which is then closer to scientific curiosity, notwithstanding ethical preoccupations.

Where women and men undertake and achieve projects together, they interact. The social link thus becomes the object of research, questioning the practices. The issue of power which is always associated concerns the lived and tangible experience of “subjects” (a term that has been favored over “individual” from the beginning of this work, increasingly used in the field of public health), as much as the functioning of the social body, organizations and institutions or the interpersonal relations of domination and submission. It may seem that, behind a common language, words have a shared meaning. This is not always the case, and the underlying paradigms propel us into a form of complexity of which the multireferentiality enables the measurement of what separates and what unites within a melting pot of concepts fed by knowledge of varied nature, which we will return to. It is this melting pot that interests us in our work: the differences then take on as much importance as the common points. Adopting this multireferenced view means moving away from simplistic views and ways of thinking. In the face of complexity, mediatization can generate “undifferentiating” linguistic productions, to use the words of Ardoino, but can also spread knowledge and open up for the necessary expression of these differences.

“We are at constant risk of remaining prisoners of the unidimensional analysis of language, a posture which can be maintained through an undifferentiating syncretic perception, if mediatized. Working without sufficient demand on language productions, which are both a material and a tool for approaches that are undertaken, therefore falls back on accepting to generate alienation, while heavily jeopardizing the decisions that must constantly be taken in the plan of action” (ibid). This is why it is preferable to find, sort, distinguish, recognize and differentiate the very diverse meanings that could be attached to the terms used, based on the interlocutors, the various partners, such as in terms of larger conjunctures in which situations fall. Jacques Ardoino (1993) added: “The luxuriance, proliferation and richness of social practices concretely forbid their classical analysis using a decomposition-reduction method. This is probably one of the reasons for the contemporary rehabilitation of the term complexity”.

The temptation to reduce what is “complex” into “simplified” units is great, although we know that the whole is superior to the sum of its parts. Paradox and contradiction become imperatives imposing themselves on the researcher. The opposing argument cannot be secluded in a laboratory. It benefits from both instances of formal research as well as informal spaces that convoke research without having necessarily invoked it in anticipation. It is probably in this tight link between “research” and “intervention” that our works naturally anchored themselves initially in a doctoral thesis on tobacco-free schools, and then in the design of the education, health, and territory mechanism. The question of mechanisms implemented to intervene between “education” and “health” remains at the heart of the reflection that we wish to engage in here. Following the collection of scientific data comes the permanent question of how to intervene within a translation (language experts will speak of “transposition”) which seems to have been admitted into a professional field between scientific knowledge and practical application? Then appears the ghost of “good practice”, of something that will be “good” to apply in order to tranquilize the practitioners by acting in the most adapted way. However, be careful: we have not fallen into a fantasy of believing that the contexts resemble each other and can be overcome by the power of interventions with enough strength to do so. For the latter, inexorably, incessantly push us back to a principle of reality. Nevertheless, believing in a subject that has the resources and potential to allow the appropriation of what the facility (in the sense of “what is put at its disposal”) provides as methods of proceeding seems to us to be an essential path that we will attempt to shed light on, at least in part, including a trip to the training field at the end of the book.