Berlin Institute of Health and Nursing Science, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.
School of Public Health and Tropical Medicine, Tulane University of New Orleans, New Orleans, LA 70112, USA.
Int J Environ Res Public Health. 2020 Apr 9;17(7):2577. doi: 10.3390/ijerph17072577.
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.
健康素养 (HL) 在解释健康差距方面起着关键作用。学校护士 (SN) 在学校环境中提供与健康相关的专业知识。一些研究表明，SN 对儿童、教师和家长的 HL 都有积极影响，但现有信息仍存在差距。作为一个试点项目，SN （在德国学校中并不常见）被安置在德国两个州的 28 所公立小学和中学。2017 年基线 (T0) 调查中，儿童 (11 岁以上，n=2773)、家长 (n=3978) 和教师 (n=420) 参与了调查。数据收集在 2018 年重复 (T1)。HL 使用儿童健康素养量表 (HLSAC) (儿童) 和欧洲健康素养短量表 (HLS-EU-Q16) (成人) 进行测量。进行了描述性和多变量数据分析。所有组的 HL 在 T0 和 T1 之间都有所增加。儿童 HL 低的比例从 17.9%下降到 14.9%。家长 HL 问题和不足的比例从 43.8%下降到 38.8%，教师 HL 问题和不足的比例从 49.9%下降到 45.8%。儿童和家长的改善具有统计学意义，但教师的改善没有统计学意义。尽管干预时间相对较短，干预范围相对不具体，但有证据表明 SN 可能有助于加强学校环境中的 HL。应进一步研究 SN 对健康素养和儿童健康的长期影响。为此，必须更清楚地了解德国 SN 的工作范围，包括他们的教育干预措施。
