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. 2026 Apr 5;16:16527. doi: 10.1038/s41598-026-46477-y

Table 5.

Associations of SHDs’ health literacy with overall and domain-specific HPS implementation (school-level regressions).

HPS total Adherence Dose Participant Responsiveness
β 95%CI β 95%CI β 95%CI β 95%CI β 95%CI β 95%CI β 95%CI β 95%CI
Constant 1.456*** [1.352,1.559] 1.547*** [1.121,1.974] 1.226*** [1.106,1.346] 1.565*** [1.117,2.013] 1.720*** [1.598,1.842] 1.774*** [1.298,2.251] 1.616*** [1.460,1.772] 1.618*** [0.981,2.254]
SDH-HL (z) 0.197*** [0.099,0.295] 0.209** [0.086,0.332] 0.238** [0.092,0.384] 0.241* [0.055,0.428] 0.102 [– 0.032,0.235] 0.108 [– 0.036,0.252] 0.162* [0.009,0.315] 0.172 [– 0.010,0.354]
WSC (z) 0.051 [– 0.064,0.166] 0.085 [– 0.026,0.196] 0.053 [– 0.094,0.200] 0.004 [– 0.183,0.191]
Sex (SHD) – 0.038 [– 0.270,0.194] – 0.204 [– 0.455,0.048] – 0.019 [– 0.274,0.235] 0.065 [– 0.270,0.400]
Age 0.045 [– 0.226,0.316] 0.06 [– 0.255,0.376] 0.123 [– 0.190,0.437] 0.346* [0.035,0.657]
Teaching experience (SHD, z) 0.066 [– 0.180,0.312] – 0.036 [– 0.347,0.276] 0.088 [– 0.202,0.377] – 0.229 [– 0.504,0.046]
Current role experience (SHD, z) – 0.07 [– 0.226,0.086] – 0.054 [– 0.221,0.113] – 0.13 [– 0.291,0.031] – 0.083 [– 0.318,0.152]
Number of Classes (z) 0.084 [– 0.110,0.278] 0.036 [– 0.204,0.277] 0.073 [– 0.133,0.279] 0.142 [– 0.133,0.418]
Number of Students (z) 0.028 [– 0.141,0.198] 0.057 [– 0.143,0.257] – 0.009 [– 0.204,0.186] – 0.063 [– 0.318,0.192]
School type 1 ref ref ref ref
School type 2 – 0.01 [– 0.451,0.432] 0.077 [– 0.442,0.596] 0.062 [– 0.417,0.540] – 0.111 [– 0.676,0.455]
School type 3 – 0.232 [– 0.899,0.435] – 0.012 [– 0.874,0.850] – 0.131 [– 0.974,0.713] – 0.687 [– 1.817,0.444]
Quality of Delivery Integration Program Differentiation Adaptation
β 95%CI β 95%CI β 95%CI β 95%CI β 95%CI β 95%CI β 95%CI β 95%CI
Constant 1.609*** [1.449,1.769] 1.946*** [1.287,2.605] 2.052*** [1.911,2.194] 2.047*** [1.492,2.601] 1.882*** [1.710,2.053] 1.737*** [1.027,2.446] 2.005*** [1.837,2.172] 2.169*** [1.466,2.872]
SDH– HL (z) 0.421*** [0.282,0.560] 0.465*** [0.273,0.657] 0.214** [0.075,0.354] 0.229** [0.062,0.397] 0.270** [0.080,0.459] 0.270* [0.041,0.498] 0.271** [0.093,0.449] 0.287** [0.074,0.500]
WSC (z) 0.063 [– 0.101,0.227] 0.083 [– 0.077,0.244] 0.099 [– 0.071,0.269] 0.038 [– 0.149,0.224]
Sex (SHD) – 0.164 [– 0.510,0.182] 0.002 [– 0.323,0.327] 0.107 [– 0.295,0.510] 0 [– 0.387,0.388]
Age – 0.063 [– 0.530,0.404] – 0.127 [– 0.484,0.229] – 0.03 [– 0.368,0.307] – 0.054 [– 0.424,0.316]
Teaching experience (SHD, z) 0.192 [– 0.283,0.668] 0.212 [– 0.096,0.520] 0.242 [– 0.063,0.547] 0.181 [– 0.171,0.532]
Current role experience (SHD, z) – 0.091 [– 0.287,0.104] – 0.069 [– 0.307,0.169] – 0.103 [– 0.394,0.188] – 0.09 [– 0.371,0.192]
Number of Classes (z) 0.223 [– 0.054,0.500] 0.041 [– 0.156,0.238] – 0.061 [– 0.404,0.281] 0.146 [– 0.269,0.562]
Number of Students (z) 0.045 [– 0.223,0.313] 0.137 [– 0.065,0.339] 0.004 [– 0.270,0.278] 0.044 [– 0.242,0.330]
School type 1 ref ref ref ref
School type 2 0.187 [– 0.448,0.823] 0 [– 0.597,0.598] – 0.166 [– 0.845,0.514] – 0.399 [– 1.054,0.255]
School type 3 – 0.582 [– 1.742,0.578] 0.191 [– 0.576,0.958] – 0.055 [– 1.290,1.181] – 0.748 [– 2.067,0.571]

Coefficients are school-level OLS estimates with HC3 robust SEs. SDH-HL (z) = standardized school-level health literacy on social determinants of health; WSC (z) = standardized workplace social capital. Reference = category reference for school type. p < 0.05, p < 0.01, p < 0.001.