Examine school health promotion and students' use of water and sugar-sweetened beverages.

Abstract

Background: Overweight among adolescents is a global health concern, with unhealthy dietary habits, such as the consumption of sugar-sweetened beverages (SSBs), playing a significant role in its prevalence. To address this issue, the World Health Organization's Health Promoting Schools (HPS) framework aims to promote healthier lifestyles in schools. This study examines the impact of school-level factors, including program certification, on adolescents' daily water and SSB consumption, with a focus on how these factors may influence dietary behaviors.
Methods: This study approach was used to analyze data from 30.000 adolescents in secondary schools that participated in a national health survey . The survey collected information on daily water and SSB intake, and school characteristics, including program certification, urbanization, school size, and socio-economic factors. Multilevel modeling techniques were applied to assess the variance in daily consumption across schools and to explore the relationships between school-level factors and individual dietary behaviors.
Results: The study found that 4.53% of the variation in daily water consumption and 2.33% of the variation in SSB consumption were attributable to differences at the school level. Factors such as parental education, educational track, and urbanization explained some of the school-level variation in water and SSB consumption. However, school certification under the Health Promoting Schools program did not significantly influence the daily consumption of water or SSBs.
Conclusion: The findings suggest that school-level factors, including parental education and urbanization, play a significant role in shaping adolescents' daily water and SSB consumption. While the Health Promoting Schools program contributes to health promotion, its direct impact on dietary behaviors may vary depending on contextual factors. Further research is needed to explore how program fidelity and school characteristics interact to influence the success of health interventions.