Implementation of the whole school, whole community, whole child model in Makkah schools, Saudi Arabia: association with students' body mass index and academic achievement.

Objective: To assess the implementation of the Whole School, Whole Community, Whole Child (WSCC) model in public elementary schools in Makkah, Saudi Arabia, and examine its association with students' body mass index (BMI) and academic achievement. Methods: A cross-sectional study was conducted in 2022 across 20 elementary schools in Makkah using multistage cluster sampling. Participants included 385 students and 32 school staff from health-promoting schools (HPSs) and non-HPSs. Implementation of four WSCC domains; community involvement, family engagement, physical environment, and counseling services, was assessed using validated self-administered questionnaires. Academic scores, BMI, and sociodemographic data were collected. Data analysis utilized descriptive statistics, bivariate tests, Spearman correlations, and multivariable linear regression. Results: Students in HPSs reported higher WSCC implementation and academic achievement than those in non-HPSs (median score: 687 vs. 665, p = 0.009). In multivariable models, WSCC implementation remained an independent predictor of academic achievement after adjustment (B = 1.63, 95 % CI: 0.90, 2.35), whereas its association with BMI was not significant (B = 0.36, 95 % CI: -0.32, 1.04). A dual burden of underweight and overweight was observed. Conclusions: Strengthening WSCC implementation, especially mental health support, family and community engagement, and equitable policy adoption, may enhance students' learning and well-being.