School Health Education Program “Happy Life, Healthy Heart”: A Randomized Clinical Trial

Abstract

Background: School interventions based on playful activities have been shown to be good strategies for increasing children's knowledge about health, which may impact healthy habits. Objective: To evaluate whether the school health education program entitled “Happy Life, Healthy Heart” increases health knowledge and causes a change in teachers’ and students’ lifestyles. Method: Cluster randomized clinical trial including elementary school students and teachers from public schools in the city of Frederico Westphalen, Brazil. The intervention consisted of the training of teachers on topics of health, followed by classes on topics related to cardiovascular health given by these teachers to the students. The students were evaluated for nutritional status and health knowledge using the CARDIOKIDS and DAFA questionnaires, and teachers were assessed for physical activity. The Student’s t-test, the chi-square test and the two-way ANOVA test were used for comparisons between groups, and McNemar-Bowker for intra-group comparisons. P values of <0.05 were considered statistically significant. Results: A total of 473 children were included, 211 (44.6%) in the control group (CG) and 262 (55.4%) in the intervention group (IG), and 32 teachers (control = 14, intervention =18). There was no difference in health knowledge of the students after the intervention (CG 10.53 ± 0.11 vs. 11.19 ± 0.09 p = 0.061, IG 10.20 ± 0.12 vs. 11.09 ± 0, 09 p = 0.416), although 57.7% of the children of the IG reported having stopped eating pizza and drinking soft drinks (p <0.001), following the Brazilian Food Guide recommendations. Among teachers of the IG, an increase of 27.9% in physical activity level was observed. Conclusions: The “Happy life, healthy heart” program was able to change students’ eating habits and increase physical activity in teachers.