Beyond health-promoting labels: school factors shape pupils’ leisure-time physical activity

Abstract Background Childhood physical inactivity is rising globally and in Israel, posing a major public health challenge. Schools are pivotal settings for fostering lifelong physical activity habits. This study examined which pupil and school characteristics are associated with higher levels of leisure-time physical activity (LTPA). Methods A cross-sectional survey was conducted among 1,398 pupils (ages 10-12) and 134 parents in 29 elementary schools across Israel, including 14 Health Promoting Schools (HPS). Data on LTPA, school sports activities, school climate, parental involvement, and health policies were collected via validated questionnaires. Statistical analyses included ANOVA, Pearson correlations, and ordinal logistic regression. Results Participation in school sports activities (OR = 2.47, 95% CI: 2.14-2.86, p<.001) and a positive school climate (OR = 1.26, 95% CI: 1.10-1.44, p<.001) were significantly associated with higher LTPA. Boys reported higher LTPA levels than girls (p<.001). Socioeconomic status, school population group, and HPS affiliation showed no significant associations with LTPA. Conclusions Embedding structured sports activities and nurturing positive school climates are key to promoting LTPA among pupils. Formal HPS status alone is insufficient. Public health strategies should focus on creating inclusive, daily physical activity opportunities and gender-sensitive approaches within schools to foster sustainable health habits. Key messages • School climate and PA can promote lifelong healthy habits in children's lives. • Real change in pupils’ activity levels stems from action, not affiliation.