Health Practice Deficits and Their Determinants Among School Learners in Low-Resource Philippine Districts

Health is a multidimensional construct encompassing physical, mental, emotional, intellectual, spiritual, social, and environmental well-being. Among school-age populations, establishing sound health behaviors is critical, as patterns formed during childhood and adolescence tend to persist into adulthood. This study investigated the health practices of Grade 6, Grade 9, and Grade 12 learners in the Reina Mercedes District, Division of Isabela, Philippines, during the school year 2020–2021, employing a convergent parallel mixed-methods design to capture both the breadth and depth of student health behaviors. On the quantitative strand, a researcher-made questionnaire (Cronbach's alpha = .86) assessed 114 health behaviors across six dimensions: physical health, comprising personal hygiene, health and safety habits, nutrition, dental health, and fitness and wellness, along with mental and emotional health, intellectual health, spiritual health, social and reproductive health, and environmental health, using a four-point Likert-type frequency scale. A stratified random sample of 228 respondents was drawn from 9 elementary and 2 secondary schools using Slovin's formula. On the qualitative strand, structured and semi-structured interviews and focus group discussions with 74 participants generated contextual data, which were analyzed using thematic analysis. Quantitative results showed that all category means fell within the Very Often range (2.50–3.24), reflecting generally favorable self-reported health behaviors. Annual dental visitation was the sole Never-rated practice (M = 1.59). Thematic analysis yielded 19 emergent themes, including restricted outdoor recreation, body odor, inadequate water intake, sleep deprivation, and adolescent substance use. Integrating both strands reveals that moderate adherence to health behaviors coexists with structural barriers, poverty, low parental educational attainment, pandemic restrictions, and digital saturation, which impede optimal health practices. These findings underscore the urgent need for a comprehensive, multi-dimensional, community-partnered school-based health education program across all grade levels.