The role of school principals’ characteristics for organizational health literacy in schools

Abstract Background School health represents a neglected public health action area. Organizational health literacy in schools is a novel, equity-driven, whole-of-school approach that targets the promotion of health literacy within the setting. School principals play a key role in adapting organizational structures and implementing health-promoting interventions. This study explores the relationship between school principals’ characteristics and organizational health literacy in schools. Methods Data collection was conducted between Nov 2022 to Jul 2023. Members of the school management team of schools in Germany completed an online survey. Alongside sociodemographics, organizational health literacy in schools was assessed using an 8-item self-report scale (OHLS-Q-SF). Each item reflects one area in which a school can become health literate. Descriptive statistics, Mann-Whitney-U tests, and Kruskal-Wallis tests were conducted. Results N = 598 management board members (73.6% female, 80.7% principals) participated in the survey. Participants mainly worked at primary schools (49.1%), were 46 to 60 years old (66.2%), and had over 10 years of working experience (40.2%). Group differences between sociodemographic characteristics were found for the areas of health literacy of students, daily school life, communication, health literate school staff, and networking. For example, “health literacy in students” was rated higher in females (p < 0.001) and principals (vs. deputies; n = 540; p = 0.03). Kruskal-Wallis tests also revealed differences for school type (p < 0.01) and working experience (p = 0.021). Conclusions Most differences were detected for areas of the schools’ organizational health literacy addressing the individual level. Other areas (i.e., school development) might not be within the scope of control of the school management. Future studies are needed to explore the actual pathways between school principals and organizational health literacy to achieve public health goals in schools.