An Evaluation of the Nutrition and Health Awareness (NHA) Program on Health Knowledge, Health Literacy and Activity Levels

Abstract

Research Objectives

The Nutrition and Health Awareness (NHA) program aims to educate and cultivate positive attitudes towards health and wellness in a school-based setting. Education on physical activity, diet, and oral hygiene were emphasized.  The study’s purpose was to evaluate the effectiveness of the curriculum on increasing physical activity and health knowledge.

Study Design/Methods

A team of medical students developed and administered lessons to 93 eligible 4th-grade students at Superstition Springs Elementary School on topics such as physical exercise, nutrition groups and labels, sugar metabolism, heart disease, and oral hygiene. At baseline (Week 0), participants were randomly assigned anonymized ID numbers and Fitbit Flex 2TM accelerometers, and completed a pre-intervention questionnaire evaluating their knowledge, health literacy and attitudes. Accelerometers were used to monitor activity levels throughout the duration of the six-week program. Five lessons were provided once weekly during Weeks 1–5. One week after lessons concluded, participants were again assessed using the questionnaire.

Principal Findings and Quantitative/ Qualitative Results

Ninety-three students participated in this research. Paired pre/post questionnaires (n=81) suggest students are more likely to exercise daily (p=0.021) and know more about their health (p=0.029). Students also scored higher on questions testing their cognitive ability to correctly identify healthy foods, portion sizes, importance of exercise, dental hygiene, and risk factors of diabetes and heart disease. Fitbit accelerometers recorded activity levels (n=84) as average steps students walked every week. Due to technical difficulties, no baseline (Week 0) average activity was established. Average activity levels over 5-week period did not differ due to inconsistent data collection.

Conclusions/Impact on Health Centers

Application of the NHA program showed noteworthy improvements in health literacy, specifically in understanding of individual health, which suggests the curriculum’s potential to be used in an educational setting. Furthermore, by using a tool, such as the NHA questionnaire, to screen for health literacy in pediatric patients, healthcare providers can deliver personalized health education and care. Future research should focus on how to effectively measure activity levels, as well as how to involve the whole family in health and wellness improvement. Additionally, future research should be aimed at assessing long term retention of health knowledge.