The Effects of a Health Education Curriculum on the Knowledge, Attitudes, and Practices of Primary School Students in Beijing, China toward Health-Related Themes: A Cluster Randomised Control Trial

Background: Most primary school students in China tend to show low health literacy and low adherence levels to healthy behaviors. Health education based on school has been shown to be effective in past studies, but separate health education curricula are rarely used in Chinese schools. This study evaluates the effects of a school-based health education curriculum on students’ knowledge, attitudes, and practices (or behaviors) (KAP) toward health. Methods: : This study uses a cluster randomised controlled trail. Four primary schools were selected and randomly assigned into a control group (n=165) and intervention group (n=262). A one-semester Health Education Curriculum System (HECS) for senior grade pupils was implemented in the intervention group, and the control group was only given a 1-hour health education lecture. The evaluation was assessed from baseline, post-intervention, and 1 year after intervention by changes in students’ KAP on oral health, screen time, physical activity, and other lifestyle choices. Data were collected through questionnaires and analyzed with SPSS 20.0 using Chi-square and ACNOVA. Results: : We found that the knowledge score increased immediately after intervention with a slight decrease in the follow-up stage, significant adjusted changes (95% CI) between the intervention and control groups in score was 5.83 (5.31 to 6.36) at post intervention and 2.59 (2.04 to 3.14) in 1 year follow-up. The prevalence of health-related behaviors were also enhanced to various extents from 13% to 38% between baseline and the post education stage in the intervention group ( P <0.05), and pupils showed higher adherence to health choices than the control group at post-intervention and follow-up (P<0.05). Conclusion: The current study shows that the health education curriculum can have positive effects on improving primary school students’ health KAP. Trial registration: The study registered with the Medical Ethics Board of Capital Medical University (Z2019SY063) on October 2019. And retrospectively registered in Chinese clinical trial registry on 07/12/2022 (ChiCTR2200066506).