School principals stress, wellbeing, and health literacy during the Pandemic

Abstract Background Mental health of school principals is poorly researched in public health, despite principals being critical to the success of sustainable school development. They are the key agents enabling and leading the implementation of school health promotion, which elevates the importance of their mental health state. Evidence shows that principals are more likely to suffer from work-related stress and psychological strain, but given the additional stress during the Covid-19 pandemic, their mental health was more at risk. Health literacy could be an asset in the interplay of mental health and stress. The aim of this study is to examine the associations between principals’ corona-specific health literacy and their perceived stress, wellbeing, and psychosomatic complaints. Methods As part of the international COVID-HL school principal survey, an online study among German school principals in four federal states was conducted during the third infection wave (Mar-Apr 2021). Health literacy, perceived stress, wellbeing, and psychosomatic complaints were measured using self-report tools. Descriptive statistics, variance with subsequent post-hoc analyses and effect sizes were computed. Results A total of N = 2186 principals completed the survey, with 60.5% showing an adequate, 31.4% a problematic and 8.1% an inadequate health literacy level. Welch's ANOVA indicated significant differences between the health literacy levels and perceived stress (F(2, 423.734) = 69.51, p < 0.001; η2 = 0.06) as well as wellbeing (F(2, 407.343) = 33.463, p < 0.001; η2 = 0.034). One-way ANOVA showed significant differences between health literacy and psychosomatic complaints (F(2, 1775) = 15.94, p < 0.001; η2 = 0.018). Conclusions The findings emphasize that health literacy could be an asset for principals’ mental health, suggesting to include health literacy more frequently to public mental health promotion interventions. This will require an acknowledgment from public health and educational policies.