Enhancing prevention and health promotion literacy in French primary schools through a school diary

Background

Improving health literacy from an early age is essential to reducing social inequalities in health. Schools provide a conducive environment for its development. In this context, a French cancer prevention organization (La Ligue contre le cancer) developed a school diary incorporating prevention messages and children’ drawings to strengthen knowledge, skills, and motivation to adopt healthy behaviours among fifth-grade pupils. This study aimed to evaluate its effectiveness.

Methods

A quasi-experimental study was conducted in 30 schools of Paris area in France, 21 intervention and 9 in the control group. Intervention involved either the delivery of the diary (level 1) or the delivery of the diary complemented with activities to create drawings for the next edition of the diary (level 2). Pupils completed a questionnaire to assess prevention and health promotion literacy score (ranging from 0 to 29) at baseline and at the end of the school year. Multivariate mixed models were used to compare the evolution of the score between groups. Children in the intervention group were also asked to report any changes in their health habits.

Results

A total of 635 children were included, 460 in the intervention groups (305 in level 1, 155 in level 2) and 175 in the control group. An improvement of 1.2 points in the prevention and health promotion literacy score was observed in the level 1 group and 1.6 points in the level 2 group, versus 0.4 points in the control group. Multivariate analyses indicated a significant improvement in the level 1 (p = 0.041) and in the level 2 group (p = 0.004) compared with the control group. Children in the intervention groups also reported that the diary influenced their screen time, physical activity, and sleep habits.

Conclusions

The diary may engage children in prevention and health promotion and support health literacy in school settings. Its effectiveness could be enhanced by children participation in drawing production.

Key messages

• This study assessed the effectiveness of a school diary, developed in France by La Ligue contre le cancer, in developing children’s prevention and health promotion literacy.

• The findings highlight the importance of a participatory approach that incorporates peer-generated drawings into the diary.