HealthLit4Kids study protocol; Crossing boundaries for positive health literacy outcomes

Background: Health attitudes and behaviours formed during childhood greatly influence adult health patterns. Thispaper describes the research and development protocol for a school-based health literacy program. The program,entitled HealthLit4Kids, provides teachers with the resources and supports them to explore the concept of healthliteracy within their school community, through classroom activities and family and community engagement.Methods: HealthLit4Kids is a sequential mixed methods design involving convenience sampling and pre and postintervention measures from multiple sources. Data sources include individual teacher health literacy knowledge,skills and experience; health literacy responsiveness of the school environment (HeLLO Tas); focus groups (parentsand teachers); teacher reflections; workshop data and evaluations; and children’s health literacy artefacts anddescriptions. The HealthLit4Kids protocol draws explicitly on the eight Ophelia principles: outcomes focused,equity driven, co-designed, needs-diagnostic, driven by local wisdom, sustainable, responsive, systematicallyapplied. By influencing on two levels: (1) whole school community; and (2) individual classroom, the HealthLit4Kidsprogram ensures a holistic approach to health literacy, raised awareness of its importance and provides a deeperexploration of health literacy in the school environment. The school-wide health literacy assessment and resultantaction plan generates the annual health literacy targets for each participating school.Discussion: Health promotion cannot be meaningfully achieved in isolation from health literacy. Whilst healthpromotion activities are common in the school environment, health literacy is not a familiar concept. HealthLit4Kidsrecognizes that a one-size fits all approach seldom works to address health literacy. Long-term health outcomes arereliant on embedded, locally owned and co-designed programs which respond to local health and healthliteracy needs