Official website of the journal Adolescencia e Saude (Adolescence and Health Journal)
Background: The interaction of family health climate (FHC) and school climate demonstrates a complementary and pivotal role in shaping adolescents’ lifestyles. The current study aimed to identify the indirect, direct, and total effects of family health climate and school climate on students’ lifestyle. Method: A descriptive cross-sectional design and convenience sampling method selected 400 students from eight preparatory schools in Al-Kut city, Wasit Governorate, Iraq. The inferential statistical measures included regression analysis, which was used to identify the study objectives. Adolescent Lifestyle Profile-Revised 2 and Family Health Climate Scale (FHC-scale) were used to collect data during the period spanning from November 19, 2024, to February 28, 2025. Results: Students’ mean age was 16.64 years; fathers’ education levels ranged from middle to higher education. In a simple regression model, “healthy family climate” had a significant positive effect on students’ lifestyle (β = 0.3219, p < .001). When combining the variables “family health climate” and “school climate” in a multiple regression model, the amount of explained variance in lifestyle increased to approximately 29.8% (R² = 0.2977, p < .001). Family health climate had the most significant effect, with a coefficient of 1.0149 (p < .001), compared to a coefficient of 0.3316 for school climate (p = .0001). Conclusions: Findings reveal that the family climate plays the most important and influential role in shaping healthy lifestyles, especially when positive values, cohesion, and consensus characterize its internal environment. School climate, on the other hand, provides a complementary environment that reinforces these trends when it provides the elements of a supportive climate. These findings highlight the importance of integrating family and educational efforts to promote a comprehensive and sustainable healthy lifestyle among individuals.
Adolescence is an important stage defined by fast-paced bodily development and psychological growth [1]. Environmental exposures encountered during the pubertal period may exert enduring influences on health outcomes in subsequent stages of life [2]. In the period of adolescence, one encounters vital changes that profoundly impact their physical state, mental capabilities, and identity formation [3]. This developmental stage influences enduring behaviors, and comprehending the adversities encountered during this period is essential for promoting overall well-being [4].
School climate is considered an important indicator of students’ emotional and behavioral outcomes [5]. Psychological characteristics of adolescents, including well-being, life satisfaction, ethnic and moral identity, and resilience, are directly related to the school environment [6, 7]. While a positive school environment promotes students’ and school staff’s social behaviors and supports their learning and psychological development, a negative school climate can hinder growth and development [8, 9, 10]. The results of Kara and Asil’s study suggest that school climate may have an effect on adolescents’ beliefs about a healthy lifestyle. It was found that students who reported a more favorable school climate had higher mean scores on psychological resilience and felt positive about their health [11].
A large scoping review has shown that combined family and school contact is one of the strongest protective factors for adolescent health behaviors. Too et al. [12] found that both family and school contact reduce the likelihood of engaging in risky behaviors—such as substance abuse and emotional problems. Niermann et al. [13] studied 198 parent-adolescent dyads and found that the overall perception of the family’s health climate was positively related to adolescents’ lifestyles.
A systematic literature review by Aldridge & McChesney [14], in which more than 40 studies documented positive associations between various dimensions of school climate—such as feeling safe at school and positive relationships with teachers and peers—and adolescents’ psychosocial health and health behaviors.
In a recent applied study conducted by Weeks et al. [15] on 293 sexual minority students in the United States, the variables “Family Acceptance” and “School Climate” were combined in a single regression model to predict life satisfaction. The findings indicated that minority stress partially mediated the association between school climate and familial acceptance concerning overall life satisfaction, exhibiting a direct effect alongside school climate. School climate emerged as the more robust and consistent predictor of overall, familial, and academic satisfaction. In terms of proven theoretical frameworks, Hawkins and Catalano confirmed, within the framework of risk and protective factors, that both family cohesion and school attachment together form a system that protects adolescents from behavioral deviations [16]. So, the current study aimed to identify the indirect, direct, and total effects of family health climate and school climate on students’ lifestyle.
For the current study, a descriptive cross-sectional design was employed to determine the influence of school and family health climates on adolescents’ lifestyles. The study was conducted from December 2024 to June 2025.
It included the Wasit Governorate, Al-Kut city in Iraq. The secondary schools in this area are Al-Kut Girls’ Preparatory School, Dhatt Al-Nitaqayn Girls’ Preparatory School, Al-Huda Girls’ Preparatory School, and Al-Zahraa Preparatory School, in addition to Al-Kut, Dijlah, Al-Tahrir, and Al-Jamza Preparatory Schools for Boys.
The sampling method used was a non-probability convenience sampling method of 400 students who agreed to participate in this study.
This part is about collecting demographic information from the students, which includes age, sex, parents’ level of education, household occupation, family’s socioeconomic class, and body mass index.
The Adolescent Lifestyle Profile-Revised 2 (ALP-R2) is a self-report assessment tool designed to measure health-promoting behaviors in adolescents. The scale consists of 44 items and examines several dimensions of adolescent health: physical activity, nutrition, health responsibility (health care and prevention), stress management, interpersonal relations, spiritual health, and other dimensions related to a positive life perspective. The ALP-R2 is a valid and reliable instrument for assessing health-promoting behaviors among secondary school adolescents [17].
The Family Health Climate Scale (FHCS) is a psychometric tool for measuring collective perceptions within families regarding health and healthy lifestyles, particularly physical activity and nutrition. Developed by German researchers Niermann, K. et al. [18], this scale assesses how well a family supports healthy habits among its members and whether the family environment encourages the adoption of healthy lifestyles. Scale dimensions: the scale consists of four main dimensions: Value, Communication, Cohesion, and Consensus. Each item is rated on a Likert scale ranging from definitely false to false, true, and definitely true. The scale is used in research on family health, public health, health education, and health psychology.
Developed by Bradshaw et al. [19], it measures students’ perceptions of the overall school climate, specifically regarding bullying response, teacher support, prevalence of bullying or harassment behaviors, and students’ willingness to seek help from the teaching staff. The subscales include Willingness to Seek Help (9 items), such as “If another student brought a gun to school, I would tell a teacher.” Prevalence of Bullying and Harassment (3 items), such as “Bullying is a problem at this school.” The scale uses a five-point Likert scale (1 = strongly disagree, 5 = strongly agree). It aims to diagnose the level of school climate related to safety and relationships, determine students’ willingness to report problems, examine the relationship between teaching staff support and school bullying, and evaluate the effectiveness of anti-bullying intervention programs.
The Statistical Package for Social Sciences was utilized for data analysis (SPSS, version 27). Descriptive statistical measures of frequency, percentage, arithmetic mean, and standard deviation were used to describe students’ sociodemographic characteristics. The inferential statistical measures included regression analysis, which was used to identify the effect of the study variables.
Participants’ sociodemographic characteristics are presented in Table 1 (N = 400). The mean age of participants was 16.64 ± 1.75 years. More than half were aged 15–16 years (n = 206; 51.5%), followed by those aged 17–18 years (n = 165; 41.25%), and those aged 19–20 years (n = 29; 7.25%), indicating that most participants were in the mid to late stages of adolescence. This age distribution reflects a typical representation of secondary school students in the study area.
Regarding fathers’ level of education, approximately one-fifth were middle school graduates (n = 79; 19.8%), followed by high school graduates (n = 75; 18.8%), bachelor’s degree holders (n = 61; 15.3%), elementary school graduates (n = 59; 14.8%), diploma holders (n = 46; 11.5%), master’s degree holders (n = 24; 6.0%), doctoral degree holders (n = 20; 5.0%), those who can read and write (n = 19; 4.8%), postgraduate diploma holders (n = 9; 2.3%), and those who are illiterate (n = 8; 2.0%).
As for mothers’ education, a quarter were elementary school graduates (n = 100; 25.0%), followed by middle school graduates (n = 78; 19.5%), diploma holders (n = 50; 12.5%), bachelor’s degree holders (n = 48; 12.0%), high school graduates (n = 42; 10.5%), those who can read and write (n = 35; 8.75%), those who were illiterate (n = 25; 6.25%), master’s degree holders (n = 12; 3.0%), postgraduate diploma holders (n = 7; 1.75%), and doctoral degree holders (n = 3; 0.75%). These findings highlight noticeable differences in parental education levels, which may influence students’ perceptions and behaviors.
The results presented in Table 2 show that school climate alone accounts for approximately 8% of the variance in students’ lifestyle. Although this contribution is moderate, it emphasizes the importance of the educational environment in shaping students’ behavior and well-being.
As shown in Table 3, family health climate has a statistically significant and positive effect on students’ lifestyle, with a p-value of .0000. This strong association underscores the pivotal influence of family dynamics on the adoption of healthy lifestyle habits.
According to Table 4, school climate also has a significant positive effect, and the combined influence of family health climate and school climate accounts for approximately 29% of the variation in students’ lifestyle outcomes, indicating a synergistic interaction between home and school environments.
The model presented in Table 5 further confirms that both family health climate and school climate have statistically significant positive effects on students’ lifestyle, with p-values of .0000 and .0001, respectively. This demonstrates that comprehensive efforts at both familial and institutional levels are essential for fostering a healthy adolescent lifestyle.
| Variable | F | % |
|---|---|---|
| Age (Years): | ||
| 15-16 | 206 | 51.5 |
| 17-18 | 165 | 41.25 |
| 19-20 | 29 | 7.25 |
| Mean (SD): 16.64 ± 1.75 | ||
| Sex | ||
| Male | 200 | 50 |
| Female | 200 | 50 |
| Father’s level of Education | ||
| Unable to read and write | 8 | 2 |
| Read and write | 19 | 4.8 |
| Elementary school | 59 | 14.8 |
| Middle school | 79 | 19.8 |
| High school | 75 | 18.8 |
| Diploma | 46 | 11.5 |
| Bachelor’s degree | 61 | 15.3 |
| Postgraduate diploma | 9 | 2.3 |
| Master’s degree | 24 | 6 |
| Doctoral degree | 20 | 5 |
| Mother’s level of Education | ||
| Unable to read and write | 25 | 6.25 |
| Read and write | 35 | 8.75 |
| Elementary school | 100 | 25 |
| Middle school | 78 | 19.5 |
| High school | 42 | 10.5 |
| Diploma | 50 | 12.5 |
| Bachelor’s degree | 48 | 12 |
| Postgraduate diploma | 7 | 1.75 |
| Master’s degree | 12 | 3 |
| Doctoral degree | 3 | 0.75 |
| \(R\) | \(R\)-sq | MSE | \(F\) | df1 | df2 | \(p\) |
|---|---|---|---|---|---|---|
| .2831 | .0802 | 81.2078 | 34.6802 | 1.0000 | 398.0000 | .0000 |
| coeff | se | \(t\) | \(p\) | LLCI | ULCI | |
| Constant | 26.3007 | 2.7288 | 9.6382 | .0000 | 20.9361 | 31.6654 |
| Family health climate | .3219 | .0547 | 5.8890 | .0000 | .2144 | .4293 |
|
coef: Coefficient, LLCI: Lower limit confidence interval, \(p\): P-value, se: Standard Error, \(t\): T-statistics,
ULCI: Upper limit confidence interval |
||||||
| \(R\) | \(R\)-sq | MSE | \(F\) | df1 | df2 | \(P\) |
|---|---|---|---|---|---|---|
| .5456 | .2977 | 224.3207 | 84.1483 | 2.0000 | 397.0000 | .0000 |
| coeff | se | \(t\) | \(p\) | LLCI | ULCI | |
| Constant | 50.0739 | 5.0369 | 9.9415 | .0000 | 40.1717 | 59.9762 |
| Family health climate | 1.0149 | .0947 | 10.7152 | .0000 | .8287 | 1.2011 |
| School climate | .3316 | .0833 | 3.9803 | .0001 | .1678 | .4954 |
|
coef: Coefficient, LLCI: Lower limit confidence interval, \(p\): P-value, se: Standard Error, \(t\): T-statistics,
ULCI: Upper limit confidence interval |
||||||
Fathers’ education levels ranged from middle to higher education. Most (69.2%) had middle school to bachelor’s degrees. Mothers’ education level showed slightly lower educational attainment. The largest group was elementary school (25%). These findings differ from previous studies in Iraq, such as one conducted in Najaf, where 28.2% of fathers had an institute or college degree, and 26.4% of mothers had completed middle school [20]. Similarly, a 2023 study in Baghdad by Jabr and Mohummed found that 29.9% of fathers had an institute or college education, while 28% of mothers had completed intermediate school [21]. Another 2020 study in Baghdad indicated that 22.9% of fathers were secondary school graduates, whereas 24.3% of mothers had completed intermediate school [22].
The simple regression results in Table 2 showed that school climate explained approximately 8% of the variance in students’ healthy lifestyle behaviors (R² = 0.0802, p \(<\) .001). This suggests that school dimensions—such as academic support, fairness, and mutual respect—play an important role but are not the only determining factor, with 92% of the variance remaining unexplained by other factors. In similar contexts, school climate has explained even more variance when included as a multidimensional factor. For example, a multiple regression model revealed that school climate explained approximately 35% of the variance in students’ psychological resilience (R² = 0.353, p \(<\) .01) and was positively correlated with well-being and negatively with bullying. This suggests that positive school climates could promote students’ resilience and well-being and reduce bullying [23].
In a simple regression model (Table 3), “healthy family climate” had a significant positive effect on students’ lifestyle (\(\beta\) = 0.3219, p \(<\) .001). This finding supports Niermann et al.’s study of 198 parent-adolescent dyads, which found that the overall perception of the family’s health climate was positively related to adolescents’ physical activity standards [13].
When combining the variables “family health climate” and “school climate” in a multiple regression model (Tables 4 and 5), the amount of explained variance in lifestyle increased to approximately 29.8% (R² = 0.2977, p \(<\) .001). Family health climate had the most significant effect, with a coefficient of 1.0149 (p \(<\) .001), compared to a coefficient of 0.3316 for school climate (p = .0001), indicating that the family environment has a greater impact on shaping students’ health behaviors than school climate. The FHC, which emerges through family interactions and shared time, has been shown to affect various aspects related to the health behavior of individual family members, and it is a key factor for families’ health regarding nutrition and physical activity [24].
A large scoping review has shown that combined family and school contact is one of the strongest protective factors for adolescent health behaviors. Too et al. [12] found that both family and school contact reduce the likelihood of engaging in risky behaviors—such as substance abuse and emotional problems. In terms of proven theoretical frameworks, Hawkins and Catalano confirmed, within the framework of risk and protective factors, that both family cohesion and school attachment together form a system that protects adolescents from behavioral deviations [16].
In a recent applied study conducted by Weeks et al. [15] on 293 sexual minority students in the United States, the variables “Family Acceptance” and “School Climate” were combined in a single regression model to predict life satisfaction. The findings indicated that minority stress partially mediated the association between school climate and familial acceptance concerning overall life satisfaction (p \(<\) 0.001), exhibiting a direct effect alongside school climate (p = 0.006). School climate emerged as the more robust and consistent predictor of overall, familial, and academic satisfaction.
Findings reveal that the family climate plays the most important and influential role in shaping healthy lifestyles, especially when positive values, cohesion, and consensus characterize its internal environment. The school climate, on the other hand, provides a complementary environment that reinforces these trends when it includes elements of a supportive atmosphere. These findings highlight the importance of integrating family and educational efforts to promote a comprehensive and sustainable healthy lifestyle among individuals.
It is recommended to develop basic intervention programs that promote positive values, family cohesion, and consensus within the family. These programs could include workshops and educational courses for families aimed at adopting a healthy lifestyle that supports the physical and psychological development of family members.
Develop appropriate interventions and programs that align with the specific needs of each grade level and suit the maturity levels and interests of students.
Enhance joint cooperation between teachers and parents. Joint initiatives and programs, such as educational and sports activities and interactive seminars that integrate family support, can be designed and implemented within the school environment.
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