School Health Promotion Policies and Adolescent Risk Behaviors in Israel: A Multilevel Analysis.
Health promotion policies targeting risk-taking behaviors are being implemented across schools in Israel. This study identified the most effective components of these policies influencing cigarette smoking and alcohol consumption among adolescents.



Logistic hierarchical linear model (HLM) analysis of data for 5279 students in 95 Jewish public schools from the Health Behavior in School-Aged Children (HBSC) 2010-2011 survey in Israel enabled simultaneous estimation of the relationship between student- and school-level variables (health promotion policy) to alcohol consumption and smoking behavior. Principals of participating schools also were interviewed to ascertain their degree of adoption and implementation of a health promotion policy.



Most of the variance in adolescent risk behaviors is explained by student-level variables: negative perceptions of school, lack of parental support for school issues, and more time spent with friends. Among the school-level policy measures, parental participation in health promotion intervention programs was repeatedly associated with lower rates of risk behaviors, over and above student characteristics.



School health promotion policies should focus on parents' involvement in intervention programs and should seek to improve students' perceptions of school and their sense of well-being to promote resilience. Further research is needed to identify additional factors that may increase the effectiveness of school health promotion policies.
Faculty of Social Welfare and Health Sciences, School of Public Health, Mount Carmel, Haifa 3498838, Israel. riki.tesler@gmail.com.
Riki
R
Tesler
International Research Program on Adolescent Well-Being and Health, School of Education, Bar-Ilan University, Ramat Gan 52900, Israel. harelyossi@gmail.com.
Yossi
Y
Harel-Fisch
Faculty of Social Welfare and Health Sciences, School of Public Health, Mount Carmel, Haifa 3498838, Israel. ornaepel@research.haifa.ac.il.
Orna
O
Baron-Epel
D000293:Adolescent; D000294:Adolescent Behavior; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D005195:Family Relations; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007557:Israel; D008297:Male; D055361:Multilevel Analysis; D012309:Risk-Taking; D012572:School Health Services / Q000458:organization & administration*; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D012944:Social Support; D012959:Socioeconomic Factors
adolescence; alcohol consumption; health promotion; risk behavior; school policies; smoking