Health-Promoting Schools in Israel, Applying the Ottawa Charter for Health Promotion

School-based health promotion programs can improve children's health outcomes. This study examined levels of implementation of health promotion by Areas of Action in health-promoting schools (HPS) and non-HPS in Israel.

A cross-sectional survey was conducted among principals from 637 of 771 Israeli elementary and middle schools (52% Jewish, 48% Arab). The questionnaire assessed school activities according to Action Areas and domains of the Ottawa Charter.

HPS recognition rates were 64% in secular Jewish schools and 69% in Arab schools. Among non-HPS schools, 54% (n = 164) reported health promotion activities. HPSs had higher activity levels than non-HPSs in the domains of policy (M = 7.79 vs. 5.45), environment (7.78 vs. 6.85), health education (2.01 vs. 1.67), and staff training and empowerment (1.71 vs. 0.97), all p < 0.001. Community involvement was also higher (90.8% vs. 58.6%, χ² (1) = 62.92, p < 0.001. In Jewish schools, a higher socioeconomic status (SES) correlated with increased activity (B = 0.13, β = 0.107, t = 2.38, p < 0.05). Among Arab schools, SES was not significantly related to most domains, except for staff training and community involvement, where associations were negative.

A comprehensive, equity-oriented policy is needed to ensure equal opportunities for health promotion, particularly in underserved communities.

Strengthening the implementation of the Ottawa Charter principles alongside formal recognition of HPSs is fundamental to advancing effective school health promotion.