School-Based Interventions to Improve Health Literacy

School-based interventions show promise for improving health literacy among rural children. School-based interventions have shown promise in improving children's health outcomes and may reduce health disparities. Strengthening the integration of personal health literacy and school health education can also help future generations. Evidence points to collaboration between health education and health literacy further improving health and overall well-being, including building communication efforts among schools, parents, students, public health officials, and other community partners.

One example of a school-based intervention is school-based health centers (SBHCs), which provide primary healthcare services to students in kindergarten through 12th grade, either within a school building or at another location. SBHCs in certain locations may also provide care to family members and other community members who do not have children enrolled in the school. SBHCs can improve health literacy among students and their families by building health self-efficacy, increasing healthcare access, and increasing knowledge about health information.

Examples of School-Based Interventions to Improve Health Literacy

• Healthy Schools Healthy Communities (HSHC) is an initiative that works with K-8 schools in 32 school districts in Missouri. HSHC implements wellness assessments and action plans to reduce childhood obesity in these school districts. The action plans encourage multi-level engagement at the student, family, and community level to improve health literacy by increasing access to healthy food and physical activity.
• The River Valley Healthy Communities Coalition (RVHCC) Health Information Literacy Outreach Project developed a health information literacy curriculum that was piloted by teachers and librarians in schools in rural Oxford County, Maine. The intended audience was young adult students. The curriculum includes three lessons on finding health information online, evaluating reliability of information, using the information to learn about personal health, and sharing these skills with older family or community members.
• University of Maryland, Herschel S. Horowitz Center for Health Literacy partnered with Atlantic General Hospital and Worcester County Public Schools to develop the Integrated Health Literacy Program (IHLP). The IHLP was implemented in every public school in Worcester County, Maryland, for students in first through eighth grade. The program helped teachers embed health literacy concepts into their curriculums.

Program Clearinghouse Examples

• Cornerstone Care utilizes the CATCH model (Coordinated Approach to Child Health) in schools to train physical education teachers and other school staff to promote exercise and increased activity in kids.

Implementation Considerations

Schools offer an ideal location for health literacy programming for rural children and adolescents. Schools are often the hub of a community, and teachers and school administrators are often trusted community members. Teaching health literacy skills from an early age can empower youth to manage their health and well-being and to ultimately navigate the healthcare system once they are older. Programs implementing a school-based intervention should consider addressing specific health needs of community members.

Research shows that incorporating health literacy curricula into the school day ensures all students have improved access to important health programming. These interventions, however, often occur after school, rather than during the instructional portion of the school day.

For additional implementation considerations related to implementing SBHCs and other school-based health programs, see the School-Based Services Integration Model in the Rural Services Integration Toolkit.