Integrating Health Literacy in Schools: A Feasible, Equity-Focused JACARDI Pilot

Issue

While schools are ideal for health promotion, top-down interventions often struggle to achieve the deep contextual adaptation needed for sustainable impact. This pilot, within the EU Joint Action JACARDI, integrates health literacy into school curricula in Aragon, Spain, providing a model for equity-focused interventions.

Description

16 Health Promoting Schools in Aragón were engaged through the JACARDI project and Ophelia framework. 28 co-design workshops with school community facilitated the implementation of 46 activities, ranging from curriculum-integrated healthy eating/physical activity modules to staff training. A Plan-Do-Study-Act (PDSA) framework guided assessment of feasibility, alignment and engagement, and identified necessary adaptations, while diversity was managed through targeted strategies (e.g., paper vs. digital resources) to ensure scalability. The project aimed to answer: (1) Is it feasible to embed health literacy into school curricula? (2) How can equity-adapted actions improve stakeholder engagement?

Results

In the final evaluation 14/16 schools participated (87.5%), with JACARDI actions rated 3.86/5. Among 10 centers reporting on specific activities, all confirmed they were feasible and effective. High adaptability was demonstrated via cultural and logistic adjustments based on school profiles (rural/urban, SES). Teachers identified “eating and well-being,” “meals,” and “screen-time” as priorities for subsequent cycles.

Lessons

Key lessons highlight that equity-oriented flexibility is essential to drive engagement and prioritize stakeholder-identified topics. Institutional support proved a primary facilitator, whereas time constraints and contextual diversity were significant barriers. This phase serves as the foundation for the next stage, enabling a refined set of actions. By fostering stakeholder ownership, this project developed school-owned practices that integrate health literacy into daily educational routines.

Key messages

• Co-designed, school-based health literacy actions are feasible and highly acceptable, successfully integrating healthy eating and physical activity into diverse school routines.

• Equity-focused adaptations enhance the transferability of the intervention, providing a model scalable for diverse school environments.