Abstract

Abstract Background The World Health Organization has defined school systems as the significant framework for health promotion, because it enables accessibility to most of the child population. Objectives To examine the association between health promotion policies of school principals and student-level factors that predict health behaviour patterns: physical activity and proper nutrition. Methods This cross-sectional study is based on data from the HBSC (Health Behaviour in School-Aged Children) survey that included 7,000 students in grades 6, 8, and 10 in secular and religious public schools and in Arab schools, and about 126 principals. Results The findings of the study indicate: at the student level boys perform physical activity more frequently than girls (B = 0.80, p < 0.01); with increasing age students from a high socio-economic background are more physically active (B=-0.34, p < 0.01); and students in religious public schools perform less physical activity compared to students in secular public schools (B=-0.37, p < 0.01). At the multi-level, implementation of a policy that encourages physical activity is a predictor of physical activity habits at the student level (B = 0.09, p < 0.05). Moreover, findings show that school nutrition policies (OR = 0.89, p < 0.05) and principals' commitment to health promotion (OR = 1.13, p < 0.01) predict healthy eating habits among students. Findings also indicate that students in the Arab sector consume less healthy food compared to students in public schools (OR = 0.54, p < 0.05). Conclusions The results of the current study emphasize the importance of implementing health promotion policies in schools among principals to improve students' physical activity and healthy eating habits.

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