Evaluation report
Potentials of School Nursing for Strengthening the Health Literacy of Children, Parents and Teachers
Elke de Buhr, Michael Ewers, Antje Tannen ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This pilot project evaluated whether school nurses in German elementary and secondary schools could improve health literacy among children, parents, and teachers. Over one year, health literacy was measured in 2,773 children, 3,978 parents, and 420 teachers at baseline and follow-up. Health literacy increased across all three groups, with particularly notable improvements in children and parents, though the effect in teachers was not statistically significant.
Key points
- Low child health literacy decreased from 17.9% to 14.9% between baseline and follow-up
- Problematic and inadequate health literacy among parents dropped from 43.8% to 38.8%
- Problematic and inadequate health literacy among teachers declined from 49.9% to 45.8%, but this improvement was not statistically significant
- Improvements were statistically significant for children and parents but not for teachers
- School nurses are not common in German schools, and this was a pilot placement in 28 schools across two German states
Limitations
The intervention period was relatively short (one year) and the scope of specific interventions by school nurses was not clearly defined, making it difficult to determine which activities drove improvements. Long-term effects on health literacy and actual child health outcomes remain unknown.
Abstract
Health literacy (HL) plays a key role in explaining health disparities. School nurses (SN) provide health related expertise within the school setting. A positive effect on the HL of children but also their teachers and parents has been suggested by some research, but gaps persist in the available information. As a pilot project, SN, which are not common in German schools, were placed in 28 public elementary and secondary schools in two German states. Children (11+ years, n = 2773), parents (n = 3978) and teachers (n = 420) participated in a 2017 baseline (T0) survey. Data collection was repeated in 2018 (T1). HL was measured using the Health Literacy for School-Aged Children scale (HLSAC) (children) and the European Health Literacy Short Scale (HLS-EU-Q16) (adults). Descriptive and multivariate data analyses were carried out. The HL of all groups increased between T0 and T1. Low child HL decreased from 17.9% to 14.9%. Problematic and inadequate HL dropped from 43.8% to 38.8% among parents and from 49.9% to 45.8% among teachers. Improvements were significant for children and parents but not for the teachers. Despite the relatively short intervention period and a relatively non-specific spectrum of interventions, there is some evidence that SN may contribute to strengthening HL within the school setting. The longer-term effects of SN on health literacy and child health should be further examined. For this, a clearer conceptualization of the scope of work of the SN in Germany including their educational interventions is imperative.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Placement of school nurses in elementary and secondary schools to provide health-related expertise and education
- Population
- Children aged 11+ years (n=2,773), parents (n=3,978), and teachers (n=420) in 28 public schools across two German states
Key finding
Low child health literacy decreased from 17.9% to 14.9% (improvement statistically significant)