A decade on: exploring the Okanagan Charter's continued international relevance for health promotion in higher...

Over the past decade, the Okanagan Charter has guided health promotion in higher education, but shifts in the sector have raised questions about its ongoing global relevance. This study explored international stakeholder perspectives on the Charter's applicability and identified priority areas for potential revision. An anonymous, cross-sectional survey was developed on Qualtrics and distributed internationally via purposive sampling. The survey included 19 ordinal-scale questions, each paired with a related open-ended question and demographic questions. Quantitative data were analysed descriptively and with independent samples t-tests, while qualitative data were examined using Braun and Clarke's reflexive thematic analysis. A total of 488 participants from 48 countries responded (English, n = 455; Spanish, n = 43). The majority were aged 35-44 years (28%) and 71% identified as female. Respondents held diverse and often multiple roles, including health and well-being professionals (42%), academics (33%), administrators (26%), and students (9%). Collectively, 1951 comments were submitted. Among the participants who completed all 19 questions exploring the relevance of each Charter component (n = 330), 77.3% recommended revising at least one area. Four overarching thematic areas were identified: evolving contexts and concepts, leadership and governance, implementation and evaluation, and language syntax and comprehension. While the Okanagan Charter remains a valued document, most respondents advocated for targeted revisions to better reflect the evolving needs of higher education. These findings highlight key areas for consideration in any future iteration and underscore the importance of continued global dialogue to support healthier campus environments.