Effect of Coordinated School Health Programming on Hispanic Preschoolers' Health Knowledge: Cluster Randomized Trial

Health education provides individuals with the knowledge, skills, and attitudes needed to make informed decisions about their well-being. This study examines the impact of the Bienestar/NEEMA Coordinated School Health Program (BN CSHP) on the health knowledge of Hispanic preschool children. A cluster randomized trial was conducted as part of the South Texas Early Prevention Study-Pre-Kindergarten, which focused on 4-year-old children in school districts along the Texas-Mexico border. The primary aim compared health knowledge test (HKT) scores between intervention schools that received the BN CSHP and control schools that received another standard health curriculum. The secondary aims examined the associations between HKT scores and children's sex, age, dietary habits, body mass index, cardiorespiratory fitness (CRF), and parents' education and income levels. The assessment of the primary and secondary aims was performed via linear mixed models. After adjusting for covariates, the average HKT score for the control group increased from 57.2 to 63.6, a difference of 6.4 percentage points, whereas the intervention group's score increased from 53.9 to 66.0, a difference of 12.1 percentage points. Compared with their counterparts, girls, older children, and those with higher CRF scored higher on the HKT. Higher parental education and household income were also associated with higher HKT scores. This study demonstrated that the BN CSHP significantly improved preschool children's health knowledge, highlighting the importance of multilevel and culturally tailored health education in fostering health education.