Developing a School-based Wellness Program to Prevent NCDs: A Mixed-methods Study in Indonesian Elementary Schools

Abstract:
Introduction: Non-communicable diseases (NCDs) are the leading cause of morbidity and mortality worldwide. Schools are strategic settings for health promotion, and empowering teachers may contribute towards prevention of NCD . This study aimed to develop the School Wellness Program (SWeP) as a strategy to strengthen teacher capacity
in health promotion.
Methods: A research and development design with mixed-method approaches was applied through five phases: needs assessment, baseline, intervention, endline, monitoring, and evaluation. The study involved 164 employees, 35 teachers, and 12 elementary schools in Klaten District, Central Java, Indonesia, in 2023. Data collection included assessment of schools’ needs regarding NCD prevention, pre- and post-tests of teacher knowledge, training interventions, monitoring, and program evaluation.
Results: Teachers’ knowledge increased significantly by 21.9±20.2 points (p small from 0.001). Teachers used applied standard operating procedures to measure students’ height (83.33%), weight (93.59%), blood pressure (76.22%), and blood sugar (95.45%). Risk factors identified included smoking (9.1%), low fruits and vegetables intake (70.7%), insufficient physical activity (56.1%), alcohol consumption (3%), and sleep-related problems (22.6%). Program sustainability was supported through collaboration with health professionals.
Discussion: The findings demonstrated that teacher empowerment can enhance early NCD risk detection and health promotion in schools. Integrating structured training and monitoring ensures program feasibility and aligns with global efforts to address NCDs in low-resource settings. However, longer-term evaluation is required to assess behavioural changes among students and community-wide impact.
Conclusion: Teacher-based wellness programs are effective for school-based NCD prevention and have potential for broader scalability when supported by health professionals.