As part of the formative evaluation [34 (link)], all class nine students, as well as their Health and Physical Education (HPE) teachers and school nurses from the four schools will take part in quantitative and qualitative pre-tests. This phase will assess participants’ HL knowledge, and, needs. This phase [44 (link)] will also inform the implementation strategies [34 (link), 45 ].
The HL Intervention will be developed in three steps. First, the researchers will prepare a preliminary draft of the intervention based on the IM’s four dimensions (accessing, understanding, appraising, and applying health information [40 (link)]), and the HPE curriculum of class nine. Second, the preliminary draft will be refined based on the HL needs of the target group. This will then be further refined by the Delphi study with HPE teachers, school nurse, health education, public health and medical care experts. As part of this process, the 9th -grade HPE curriculum will be integrated into the interventions’ contents, strategies, materials, and practical facilitation of the sessions. Third, to make it more aligned with HL needs, the curriculum, and the HL domains (accessing, understanding, evaluating, and applying), the refined draft will be finalized based on consultation with health educators and health literacy experts (see Fig. 3).

Flow chart of the intervention development process

Free full text: Click here