Organizational health literacy of schools in Germany: a cross-sectional study in schools

BACKGROUND: Organizational health literacy facilitates health literacy by creating health-literate settings. The school setting is an important venue for the promotion of health literacy of children and adolescents. Within the Health-Literate Schools project (HeLit-Schools), a concept for organizational health literacy of schools was developed, with eight standards informing a questionnaire. This study aims at assessing the implementation status of organizational health literacy of schools in Germany. METHODS: School principals from primary and secondary schools in Germany were invited to take part in an online survey that was launched in winter 2022/23. The implementation status of organizational health literacy was measured using a 48-item self-report questionnaire (OHLS-Q), based on the HeLit-schools concept. Sociodemographics of principals and schools, as well as other health-related variables were assessed. Descriptive statistics were conducted using SPSS. RESULTS: The preliminary sample from two federal states comprises N = 482 principals (71% female, Ø 52.3 years old). Of the schools, 44% were primary, 41% secondary, and 15% special education schools. Overall, two-thirds of the items reflecting organizational health literacy were rated as partly or fully implemented while across the individual standards a great variance was found. Schools already participating in school promotion programs or networks (28%) reported a higher implementation status of organizational health literacy. CONCLUSIONS: This was the first ever assessment of organizational health literacy of schools based on a novel concept and questionnaire. The findings provide insights into resources and barriers for the implementation of school health literacy. German schools show a relatively high overall implementation status of organizational health literacy. Nevertheless, potential for improvement could be identified. The survey is currently ongoing and more states will provide useful data to be analysed.