Predictive index for the success of school-based healthy lifestyle programs: a key role in primary prevention of cardiovascular risk factors in Kupang city

This study aimed to develop a predictive index for assessing the success of the Clean and Healthy Living Behavior (PHBS) program in elementary schools within the working area of the Sikumana Health Center. Using a case-control design, 24 elementary schools (12 with unsuccessful implementation and 12 with successful implementation) were examined, involving 242 students and 24 teachers. Data were collected through questionnaires and observation sheets and analyzed using multiple logistic regression. The findings revealed that students' practical actions were the only significant predictor of program success (p=0.043; OR=19.362; 95% CI: 1.093-343.068). The predictive index was calculated using the formula: -10.301 + 2.963 × (Student Action Score), demonstrating overall accuracy of 79%, sensitivity of 66.7%, and specificity of 90.9% at the optimal cutoff point of 11.20. Although 52.5% of students had high knowledge levels and 66.7% of teachers showed positive attitudes, these factors did not significantly predict program success. This study emphasizes that focusing on the practical implementation of healthy behaviors by students, rather than just knowledge and attitudes, is crucial for the success of school health programs. The developed index can serve as a practical tool for identifying at-risk schools and allocating resources specifically for the primary prevention of cardiovascular risk factors.