# Health‐Promoting Schools in Israel, Applying the Ottawa Charter for Health Promotion

## TL;DR

This study in Israel shows that health-promoting schools implement more health activities than non-health-promoting schools, especially in policy, environment, and education.

## Contribution

The study provides empirical evidence on health promotion implementation in Israeli schools, highlighting disparities and the role of socioeconomic status.

## Key findings

- Health-promoting schools (HPS) showed significantly higher activity levels in policy, environment, and education compared to non-HPS schools.
- Arab schools had higher HPS recognition rates than secular Jewish schools, but socioeconomic status had different impacts on activity levels between the groups.
- Community involvement was significantly higher in HPS schools compared to non-HPS schools.

## Abstract

School‐based health promotion programs can improve children's health outcomes. This study examined levels of implementation of health promotion by Areas of Action in health‐promoting schools (HPS) and non‐HPS in Israel.

A cross‐sectional survey was conducted among principals from 637 of 771 Israeli elementary and middle schools (52% Jewish, 48% Arab). The questionnaire assessed school activities according to Action Areas and domains of the Ottawa Charter.

HPS recognition rates were 64% in secular Jewish schools and 69% in Arab schools. Among non‐HPS schools, 54% (n = 164) reported health promotion activities. HPSs had higher activity levels than non‐HPSs in the domains of policy (M = 7.79 vs. 5.45), environment (7.78 vs. 6.85), health education (2.01 vs. 1.67), and staff training and empowerment (1.71 vs. 0.97), all p < 0.001. Community involvement was also higher (90.8% vs. 58.6%, χ
2 (1) = 62.92, p < 0.001. In Jewish schools, a higher socioeconomic status (SES) correlated with increased activity (B = 0.13, β = 0.107, t = 2.38, p < 0.05). Among Arab schools, SES was not significantly related to most domains, except for staff training and community involvement, where associations were negative.

A comprehensive, equity‐oriented policy is needed to ensure equal opportunities for health promotion, particularly in underserved communities.

Strengthening the implementation of the Ottawa Charter principles alongside formal recognition of HPSs is fundamental to advancing effective school health promotion.