School health promotion during the COVID-19 pandemic: Associations with school leaders’ health literacy

Abstract Background School leaders are credited with an important role when it comes to school health promotion. During the COVID-19 pandemic, much health-related information was available and had to be interpreted and acted upon by school leaders. Therefore, it is crucial that they have sufficient health literacy as the ability to gain access to, understand and use health-related information. A study in Germany showed that limited health literacy among school principals was associated with low levels of health promotion activities. This paper explores the association between school leaders’ health literacy and school health promotion in Switzerland, addressing the following questions: 1. What is the relationship between health literacy of school leaders and the implementation of school health promotion? 2. Does health literacy explain variance above and beyond other antecedents, such as principals individual mental health and attitudes? Methods The quantitative analysis is based on an online survey conducted among school leaders in the German- and French speaking parts of Switzerland in June 2021 as part of the project “COVID-19 health literacy school principals survey”. The final sample comprised N = 339 school leaders. The data were analyzed using stepwise regression with health literacy, stress, wellbeing and attitudes toward school health promotion as antecedents and COVID-19 related school health promotion as the outcome. Results The results show that health literacy of school principals has played an important role in the implementation of school health promotion during the COVID-19 pandemic. It explains additional variance beyond other antecedents. Conclusions One way to promote implementation of school health promotion is to strengthen the health literacy of school leaders.


Background:
The health crisis caused by the COVID-19 pandemic has severely affected the education sector and its whole community. Due to their responsibility for organizing schoolwork, school managers were in an extremely challenging position. The main objective of the present study is to reveal the extent to which school principals in Poland put aside their own needs in favor of fulfilling their professional duties during the COVID-19 pandemic.

Methods:
The results come from an online survey among school principals in Poland, which is part of the international COVID-19 Health Literacy School Principals Survey. The survey was conducted in 8 out of 16 provinces in Poland between June 2021 and December 2021. 1899 school principals participated in the survey, of which 928 completed the questionnaire.

Results:
The study revealed that 68,3% of school principals often and very often worked longer than contractually agreed and 71,3% reported to be available for their colleagues, pupils, and parents in their free time. Most of them also had to give up leisure activities in favor of work (67,9%), work extra hours in their spare time (60%), waive breaks during working hours (57,3%), and did not get sufficient sleep in favor of work (50,5%). Devoting more time to work and high stress levels during the pandemic were associated with somatic complaints among respondents (e.g. muscle pain (neck, shoulder, or back) and headache).

Conclusions:
The results suggest that Polish school principals worked at the expense of their free time and health during the COVID-19 pandemic. As such, findings emphasized a lack of life-work balance and the need to raise their awareness of the consequences of self-exploitation in work in challenging times. The ability to set healthy boundaries between work and private life among managers is one of the health promotion tasks in demanding times.

Background:
School leaders are credited with an important role when it comes to school health promotion. During the COVID-19 pandemic, much health-related information was available and had to be interpreted and acted upon by school leaders. Therefore, it is crucial that they have sufficient health literacy as the ability to gain access to, understand and use healthrelated information. A study in Germany showed that limited health literacy among school principals was associated with low levels of health promotion activities. This paper explores the association between school leaders' health literacy and school health promotion in Switzerland, addressing the following questions: 1. What is the relationship between health literacy of school leaders and the implementation of school health promotion? 2. Does health literacy explain variance above and beyond other antecedents, such as principals individual mental health and attitudes?

Methods:
The quantitative analysis is based on an online survey conducted among school leaders in the German-and French speaking parts of Switzerland in June 2021 as part of the project ''COVID-19 health literacy school principals survey''. The final sample comprised N = 339 school leaders. The data were analyzed using stepwise regression with health literacy, stress, wellbeing and attitudes toward school health promotion as antecedents and COVID-19 related school health promotion as the outcome.

Results:
The results show that health literacy of school principals has played an important role in the implementation of school health promotion during the COVID-19 pandemic. It explains additional variance beyond other antecedents.

Conclusions:
One way to promote implementation of school health promotion is to strengthen the health literacy of school leaders.