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Abstract

Background: Health-promoting schools (HPS) are a key strategy for improving student health and supporting national education policy. Despite its importance, evidence on the implementation of global HPS standards (GSHPS) in diverse school settings in Thailand remains limited.

Method: A quantitative-dominant, two-phase design was used. Quantitative data were obtained from 498 school administrators using validated assessment tools (S-CVI = 4.62–5.00; α = 0.935–0.967). Data were analyzed using descriptive statistics, t-test, ANOVA, and multiple regression. Qualitative data were collected through focus groups with nine administrators and experts to contextualize quantitative patterns and provide practice-oriented insights regarding implementation feasibility.

Results: HPS implementation across the ten GSHPS components was rated at a high level, with the “Safe and Disease-Free Environment” component receiving the highest mean score (M = 4.56). Significant differences of HPS implementation, outcomes, and problems appeared for school level, school size, presence of guidance/school psychologists, and administrators' HPS knowledge. Five management and implementation-related predictors significantly explained 51% of the variance in HPS outcomes, with participatory leadership, team capacity development, and data-driven monitoring showing the strongest effects.

Conclusion: This study provides empirical insights into the status and determinants of HPS implementation in Thailand. The findings highlight organizational and leadership factors essential for strengthening health-promoting practices in schools. These results can inform targeted interventions and policy planning aimed at fostering a more sustainable health-promoting school environment.

Keywords: Data-driven decision-making, Educational management, Global standards, Health-promoting schools, Health culture, School leadership

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