Peer-reviewed article
Empowering Children: Co-Design Boosts Health Literacy and Learning Outcomes in primary school
W van Boxtel, K Jerković-Ćosić, M ChinAPaw ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study looked at whether children learn more about managing health information (health literacy) when they help design the learning activities. In three Dutch primary schools, small groups of children worked with researchers to design activities. These children and their classmates then tested the activities. Health literacy scores rose significantly in the children who co-designed the activities. Classmates who only tested them improved significantly on learning outcomes. The authors conclude that co-designing is more beneficial than only experiencing an activity.
Key points
- 66 children took part: 24 in the co-design group and 42 in the test group. Mean age was 10.8 and 62% were girls.
- Health literacy scores increased significantly over time in the co-design group.
- The peer group, who only tested the activity, had significantly higher learning outcome scores after testing.
- The co-design group already had significantly higher learning outcome scores than the peers before the test.
- The authors conclude that taking an active role in the design process contributed to a deeper understanding of health literacy.
Limitations
The sample is small, from three schools in the Netherlands. The co-design group started with higher learning outcome scores than the peers, so the claim that co-design is more beneficial may be affected by baseline differences. Learning outcomes were measured subjectively, and the abstract does not say whether children were randomly assigned to the groups.
Abstract
Abstract Background Research underscores the primary school's pivotal role in educating children on managing health information. To enhance the effectiveness of interventions, relevance for the children and engagement of children in learning activities co-design is a promising participatory method. It fosters empowerment and ownership among young learners which is needed for active involvement in learning health literacy (HL) skills. Methods Four steps of design-based research were used to design and evaluate HL learning activities with children. In the first two steps HL learning activities were co-designed in groups of 6-9 children and 2 researchers in 3 schools in the Netherlands. In the third step the co-design group and their peers tested the activities in school. For the evaluation children's HL was measured at T0, T1, T2 with HLS-Child-Q15-NL, learning outcomes (LO) were measured subjectively based on the HL skills in the learning activity at T1 and T2. The effect on HL and LO for testing and co-designing the activities was analysed for differences within and between the co-design group and the peers who only tested the activity. Results 66 Children participated in this study (n = 24 in co-design group, n = 42 in test group. The mean age was 10.8 and 62% were girls. In the co-design group HL scores increased significantly over time. The group of peers had a significantly increased learning outcomes scores after testing the learning activity. However, the co-design group started with a significantly higher learning outcomes score than the peers group before the test. Conclusions Co-designing the activity significantly increased HL and showed significantly higher LO scores, suggesting that co-designing an HL learning activity is more beneficial than experiencing it. Engaging in the design process contributed to a deeper understanding of HL and LO, which highlights the importance of an active role in learning processes.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Health literacy learning activities co-designed with children in groups of 6-9 children and 2 researchers, then tested in school by the co-design group and their peers.
- Population
- 66 primary school children (mean age 10.8, 62% girls) in 3 schools in the Netherlands: 24 in the co-design group and 42 peers in the test group.
Key finding
Health literacy scores increased significantly over time in the co-design group.
Boxtel et al. · Crossref · 1 Oct 2025