Abstract
Background: The promotion of health literacy is seen as an urgent goal in public health and education and, hence, should be integrated in the school context as a component of the holistic health promoting school (HPS) approach. However, only limited empirical studies have addressed health literacy of school staff so far. Hence, this study aimed to examine the level of health literacy among school leaders and its association with the extent of HPS implementation. Methods: A cross-sectional study with n = 680 school principals and members of the school management board from Germany was carried out at the end of 2018. Individual health literacy, attitudes, and competencies towards HPS and occupational self-efficacy served as independent variables and the level of HPS implementation was the dependent variable. Data were analyzed using univariate and bivariate analysis as well as multiple binary logistic regression. Results: 29.3% of school leaders show a limited health literacy with significantly higher values found for male respondents. Regression analyses revealed that male gender (OR: 1.91, 95% CI: 1.22–2.99), HPS attitudes (OR: 3.17, 95% CI: 2.13–4.72), and HPS competencies (OR: 3.66, 95% CI: 2.43–5.50) were associated with a lower level of HPS implementation. Furthermore, regression analyses differentiated by gender showed that limited health literacy is associated with a low level of HPS implementation for male school leaders only (OR: 2.81, 95% CI: 1.22–6.45). Conclusions: The promotion of health literacy especially for male leaders would not only result in positive effects on an individual level but also could contribute to a stronger implementation of activities on school health promotion. We suggest integrating health literacy, HPS attitudes, and competencies more strongly into the qualification and in further training of school leaders.
Highlights
Worldwide, schools as learning and teaching environments are recognized as appropriate venues for health promotion and prevention that reach a large proportion of young people, teachers, and nonteaching staff [1]
Almost half of respondents were from primary schools (48.5%), another 10% worked at a grammar school, and about 9% worked at a school for children with special educational needs
This is the first study examining the health literacy of school principals and school managers. In their overall responsibility for the entire school, school principals serve as gatekeepers for any school development process and, need to be put more firmly in the focus of school health promotion research
Summary
Schools as learning and teaching environments are recognized as appropriate venues for health promotion and prevention that reach a large proportion of young people, teachers, and nonteaching staff [1]. The promotion of health literacy is seen as an urgent goal in public health and education and, should be integrated in the school context as a component of the holistic health promoting school (HPS) approach. Only limited empirical studies have addressed health literacy of school staff so far. This study aimed to examine the level of health literacy among school leaders and its association with the extent of HPS implementation. Individual health literacy, attitudes, and competencies towards HPS and occupational self-efficacy served as independent variables and the level of HPS implementation was the dependent variable. Results: 29.3% of school leaders show a limited health literacy with significantly higher values found for male respondents. Regression analyses revealed that male gender (OR: 1.91, 95% CI: 1.22–2.99), HPS attitudes (OR: 3.17, 95% CI: 2.13–4.72), and HPS competencies (OR: 3.66, 95% CI: 2.43–5.50) were associated with a lower level of HPS implementation
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