Developing School Health Champions to Increase Health Literacy Both in School Adolescents and Community People Through Providing Health Education by the School Nurses in Bangladesh: Community-based Pre- and Post-experimental Design

Developing School Health Champions to Increase Health Literacy Both in School Adolescents and Community People Through Providing Health Education by the School Nurses in Bangladesh: Community-based Pre- and Post-experimental Design.

Health literacy is a person's decision-making ability to improve their quality of life and prevent diseases by accessing, understanding and applying health information. Health literacy in the adolescent's period can aid them to gain and understand health information which can bring positive health outcomes.

The aim of this pilot study is to examine the efficacy of health education and school health activities provided by school nurses on improving health literacy among secondary school adolescents. The study will also examine whether health education by health champions (the adolescents) is effective in improving the health literacy of the community people, and examine whether these interventions develop awareness, improve health knowledge, empower, and change behaviors of secondary school adolescents.

This intervention study aims to improve health literacy in the adolescents in Bangladesh and the school-located community. The Begum Ayesha Pilot Girl's High School in Dohar, Dhaka district will be selected as a field. First, we will place school nurses at the school, provide health checkups for both the adolescents (about n=316) and community people (about n=200), and school nurses will provide weekly health education for 3 months to the adolescents. After certifying them as "Health Champions", the health champions visit the community and provide health education activities to the community people. For both participant groups, health literacy will be measured as efficacy checking of this pilot study.

Assent and informed consent will be obtained from the participants. Autonomy, beneficence, non-maleficence, fidelity, veracity, confidentiality, and justice of the participants will be ensured. Also, anonymity will be maintained across all stages of the study.

Inclusion Criteria:

For school adolescents:

• Students who are willing to participate.
• Students who study in class 8 (Grade 8) at the time of enrollment.
• Students who are female.
• Students whose parents or legal guardians agree to give consent and are willing to participate in the study
• Students who agree to receive health checkup, and are willing to respond to the questionnaire.
• Students who will stay in the same school till study completion.

For community people:

• Persons who are aged at least 18 years old.
• Persons who are willing to participate.
• Persons who agree to receive health checkup, and willing to respond to the questionnaire.
• Persons who will attend the health education activities.

Exclusion Criteria:

For school adolescents:

• Students who are absent from school during the health checkup periods due to severe illness or without any reason or information

For community people:

• Persons who will not attend the education sessions physically.
• Persons who will not live in the community until the post-test.