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Theoretical Background and research questions/hypothesis: Despite considerable gains in some public health areas, Mississippi faces significant barriers to achieving health gains among rural and resource-limited children. For example, at 41%, Mississippi has one of the highest overweight/obesity percentages in the nation among students in grades K-12 (Kolbo et al, 2012). Due to competing academic demands, school-based health education for elementary students may not always be as age-appropriate and comprehensive as is optimal. Community-based children’s health education centers and science museums (CHEC/SM) can help fill this notable gap. But systematic evaluations to determine effectiveness of community-based health education programming delivered to elementary students via CHEC/SM is extremely lacking.
Methods: HealthWorks! is a community-based children’s health education center whose mission is to improve health literacy among Mississippi children. HealthWorks! fulfills its mission through, for example, health education programs delivered to elementary students from rural and resource-limited schools during field trips to HealthWorks! supported by the Appalachian Regional Commission (ARC). During the fieldtrips, students participate in programs such as ‘Be A Food Groupie’ (BAFG). BAFG is an interactive program designed to improve children’s health literacy by equipping them with “smart-food-know-how” across three domains: (1) comprehending food labels; (2) understanding food portion sizes; (3) understanding food groups. In order to assess BAFG’s effectiveness, 1,000 students in the 3rd through 5th grade from 11 schools participated in BAFG evaluation in 2012. The evaluation used a constructed matched comparison group design in which ‘intervention’ schools and ‘control’ schools were matched based on percentage of students who were: (1) resource-limited; (2) minority; (3) ‘proficient’ on the Mississippi Curriculum Test 2 for language. Intervention students received the pre-test, BAFG, and post-test. Comparison students received the pre-test, post-test, and BAFG.
Results: Eighty-three percent of intervention students had improved scores from pre- to post-test (M=15.57, SD=13.25) compared to 45% of comparison students (M=2.76, SD=21.67). An ANOVA calculated on difference in test score was significant at p=0.00. Even after controlling for language proficiency—an important factor when it comes to doing well on tests—intervention students were significantly more likely to show improved scores as follows: low proficiency (p=0.00); medium proficiency (p=0.00); high proficiency (p=0.05).
Conclusions: Results suggest that BAFG positively impacted health literacy among 83% of intervention students—which exceeded the 60% success benchmark set by the ARC.
Implications for research and/or practice: Although CHEC/SM are increasingly engaged in developing child-centric interactive health literacy programming, systematic evaluation to examine “whether provision of health education in these venues increases knowledge or changes behavior” among children has been extremely understudied (Freeman, 2010). Our results help fill this critical gap by providing evidence of BAFG’s positive effective on children’s health literacy. This study provides a succinct overview of the development and implementation of a matched comparison evaluation of an interactive health education program delivered to resource-limited elementary students at a community-based children’s health education center. The study can serve as a model for conducting systematic evaluations among other school-based populations. Implications for community-based interactive health education programs targeting school-aged children are discussed.