Nitika Thakur
Assistant Professor, Saraswati Nursing Institute, Dhianpura, Roop Nagar, Delhi, India.
*Corresponding Author E-mail: nitikathakur454@gmail.com
ABSTRACT:
Raising the level of health among people and communities is the goal of health care providers. Promotion of health programme include various determinants such as physical, mental, social and spiritual health. In the present study a pre-experimental design and pre-test and post-test design was used to find out the effectiveness of Health Promotion Programme. Total 300 subjects were selected by purposive sampling technique. Health Promotion Programme developed by the investigator was implemented after 7 days posttest was conducted. Descriptive and inferential statistics was used for data analysis. The results revealed that more than half of the subjects 16(54%) were in the age group of 11-12 years and majority of the subjects i.e, 174(58%) were male. Pre- test knowledge score of the subjects (13.20±4.031) and post - test knowledge score of the subjects (20.29±1.961) was observed. Hence, the knowledge score significantly increased following the implementation of the “Health Promotion Programme”. The findings also revealed that there was no significant association between socio-demographic variables and effectiveness of health promotion programme.
KEYWORDS: Effectiveness, Knowledge, Health Promotion Program, Health Promoting Behaviour, children.
INTRODUCTION:
“To ensure good health, eat lightly, breathe deeply, live moderately, cultivate cheerfulness, and maintain an interest in life.’’
Health is the complete state of physical, social, and mental well-being, not just the absence of disease or infirmity, according to the World Health Organization (WHO).
Henry E. Sigerist, a famous medical historian, first used the word health promotion in 1945 when he identified the four main functions of medicine as promotion of health, prevention of illness, restoration of the sick, and rehabilitation.1
A multi-dimensional pattern of self-initiated emotions and behaviours that promotes health, self-actualization, and self-accomplishment is known as a health-promoting lifestyle. A low-fat diet, frequent exercise, maintaining a healthy body weight, and abstaining from smoking and stress are all aspects of a lifestyle that reduces the risk of many chronic diseases. The most crucial element of health promotion is eating habits. A nutritious diet is crucial for sickness prevention. Additionally crucial to health promotion, physical activity is a global predictor of disability and mortality. As a result, changing one's lifestyle is seen as a crucial component of a strategy for health promotion and disease prevention.2
Healthy eating habits can stabilize children‟s energy and sharpen their minds. Healthy eating habits give them best opportunity to grow in a healthy way. They require extra minerals and vitamins to assist a growing body. This includes fruits and vegetables, whole grains (such as wheat, oats, and rice), calcium-rich dairy products (such as milk), and healthy proteins (fish, eggs, nuts, seeds). From the moment of conception till the end of the person's life, food has been a source of concern for them. Food gives energy to the body that it needs for physical activities and other metabolic demands. The body needs nutrients to continue growing as well as to repair worn-out and ageing tissues.3
Schools with sufficient water, sanitation, and hygiene (WASH) facilities have a dependable water system that supplies safe and enough water, particularly for hand- washing and drinking; they also have a sufficient number of student restrooms that are private, safe, and clean. Hand wash technique is necessary for all children to prevent from various infection or illness.4
The world Health Organization's (WHO) Ottawa Charter for Health Promotion has strengthened the practice of health promotion in schools. Many countries strive to implement the integrated health promotion strategies that take into account both student attitudes and behaviours as well as the school environment. The WHO's settings approach is a concept for health-promoting schools. Good health of the children is considered to be the most important part in family and community. Educators can teach them about health promotion to boost their immune system and reduces the chances of illness. It can also helps in better physical, mental, social and spiritual growth.5
PROBLEM STATEMENT:
A Pre-Experimental Study to Assess the Effectiveness of “Health Promotion Programme” in terms of Knowledge of Health Promoting Behaviour among Children (7-12yrs.) Studying in Selected Schools of Kurali, Punjab (2020-2022)
OBJECTIVES:
1. To develop and implement the Health Promotion Programme among children.
2. To determine the relative effectiveness of Health Promotion Program in terms of pre and post-test score comparison on Knowledge of health promoting behaviour among study subjects.
3. To find the association between socio-demographic variables and effectiveness of health promotion programme, among study subjects.
METHODOLOGY:
Research Approach:
Quantitative research approach
Research Design: Pre-experimental
Setting is the physical location and condition in which data collection takes place in the study.
Study was done in schools of Kurali those were situated in the vicinity of Saraswati Nursing Institute, Dhianpura. On National Highway 21, Kurali is located 26 kilometres from Chandigarh, the capital of the Punjab State. Along its three sides, respectively, are the settlements of Kharar, Ropar and Morinda. The tehsil has total population of 31060. Data were collected from three schools named International Public School Kurali, Khalsa Public School, Kurali and Garden Valley School, Kurali.
1. Purposive sampling was used to select the schools. Both male and female students of 7-12 yrs of age from International Public School Kurali, DAV Model Senior Secondary School and Garden Valley International School were taken. All Schools were English medium, so health promotion programme on health promoting behavior was developed and delivered in English language.
2. The first location for data collection was International Public School, Kurali. It is situated at Paprali Road, District Roopnagar, Punjab, India. It was founded in the year 1996 and opened on 06-04-1998 and associated with the New Delhi-based Central Board of Secondary Education. It is equipped with 42 classrooms and all essential facilities. The school has total strength of 1220 students and having 3 streams Science, Commerce and Humanities for secondary classes.
Sample Size:
In this research study, the sample consists of 300 School going children between the age group of 7-12yrs studying in DAV Model Senior Secondary School, Kurali, Garden Valley International School and International Public School, Kurali.
Sample Technique:
Schools were selected by purposive sampling technique whereas subjects was selected by Total enumerative sampling method.
CRITERIA FOR SELECTION OF SAMPLE:
Inclusion criteria:
1. Children aged 7 to 12 years.
2. Both boys and girls were selected from schools of Kurali.
3. Children who were willing to participate.
Exclusion criteria:
1. Children who were sick at the time of data collection.
2. Students who were not present at the time of data collection.
Data Collection Tools and Techniques:
Tool 1: Development of socio-demographic data: sheet: The above mentioned was a tool constructed by the researcher after an comprehensive literature review from books, journal online resources and other publications. Socio- demographic data includes age, gender, area of residence, dietary pattern, religion, family type, mother and father education, as well as occupation of mother and father.
Tool 2: Development of Health Promotion Programme:
Health promotion programme was created using study topic, review of related research articles, non-research literature and objective specified in the blue print
The following actions were taken to develop the “Health Promotion Programme”
· Development of blue print of the content.
· Development of Health Promotion Programme.
· Content validity of Health Promotion Programme.
Research data was organised and arranged in a systematic manner through data analysis, which also involves using the data to test research hypothesis. On the basis of the study objectives, data analysis was planned. A master sheet was created for each section of the tool and the researcher transferred the data she had gathered onto it. Frequency and percentage calculations in descriptive statistics and percentage were used to analyse the data. Mean, SD, and inferential statistics was used. The comparison between the knowledge score on the pre and post-test was determined using the T test. The information was displayed using tables, diagrams and graphs for better understanding.
RESULTS:
|
S. No. |
DemographicVariables |
|
(n) |
Percentage (%) |
|
1 |
Age (in years) 7-8 9-10 11-12 |
62 77 161 |
|
21% 25% 54% |
|
2 |
Gender Male Female |
174 126 |
|
58% 42% |
|
3 |
Area of residence Urban Rural |
224 076 |
|
75% 25% |
|
4 |
Dietary pattern Vegetarian Non-vegetarian Eggetarian |
184 048 068 |
|
62% 16% 22% |
|
5 |
Religion Hindu Muslim Sikh Christian other |
98 000 092 010 00 |
|
66% 00% 31% 03% 00% |
Table 1(a) With respect to age group, more than half of the subjects 161(54%) were in the age group of 11-12yrs., 077(25%) in the age group of 9-10yrs. And 062(21%) were in the age group of 7-8yrs. The majority of subjects i.e 174(58%) were male and 126(42%) were female. As per area of residence, majority 224(75%) were living in an urban 076(25%) were living in an rural. As regards dietary pattern a majority of subjects were 184(62%) vegetarian, others 048(16%) were non-vegetarian and 068(22%) were eggetarian. Regarding the religion, majority of the subjects 198(66%) belongs to Hindu, 092(31%) which belongs to sikh , 010(3%) were belongs to Christian.
|
S. No. |
Demographic variables |
(n) |
Percentage (%) |
|
1 |
Type of family Nuclear Joint |
103 197 |
34% 66% |
|
2 |
Education of father No formal education but can read and write Primary Secondary Higher secondary Graduate and above |
010
047 051 127 065 |
3%
15% 17% 43% 22% |
|
3 |
Education of mother No formal education but can read and write Primary Secondary Higher secondary Graduate and above |
00
040 068 082 110 |
00%
13% 23% 27% 37% |
|
4 |
Occupation of mother Government employee Private employee Self employed House wife Labourer |
022 052 008 218 00 |
7% 18% 02% 73% 00% |
|
5 |
Occupation of father Government employee Private employee Self employed Labourer |
079 146 060 025 |
26% 49% 16% 09% |
Table 1(b) Majority of the subjects were belonged to 197(66%) joint family whereas 103(34%) subjects belong to nuclear family. About education of father of majority subjects127(43%) were educated upto higher secondary, 65(22%) were educated upto graduate and above, 51(17%) were educated upto secondary, 47(15%) were educated upto primary and only 10(3.3%) had no formal education but can read and write. Regarding education of mother majority 110(37%) subjects were graduated and above, 82(27%) were higher secondary, 68(23%) were secondary and 40(12%) were educated upto primary. As per occupation of mother, majority 218(73%) were housewife, 52(18%) were private employee, 22(7%) were government employee and 8(2%) were self employed. As per father occupation, majority 146(49%) were a private employee, 79(26%) were a government employee, 60(16%) were self employed and 25(9%) were labourer.
Table 2(a) Subject Related Physical Health.
|
Domain 1; Physical Health |
||||
|
Questions |
Pre-test |
Post-test |
||
|
Correct Answer N (%) |
Incorrect Answer N (%) |
Correct Answer N (%) |
Incorrect Answer N ( %) |
|
|
1. What are the dimensions of health? |
87(29%) |
213(71%) |
194(64.6%) |
106(35.3%) |
|
2. What are the objectives of health? |
186(62%) |
114(38%) |
270(90%) |
30(10%) |
|
3. What are the types of objectives? |
99(33%) |
201(67%) |
207(69%) |
93(31%) |
|
4. Which one of the following is a type of hygiene practice? |
212(70.6%) |
88(29.3%) |
273(91%) |
27(9%) |
|
5. What is the purpose of toilet hygiene? |
192(64%) |
108(36%) |
268(89.3%) |
32(106%) |
|
6. How often should you cutting your nails? |
57(19%) |
243(81%) |
197(66%) |
103(34.3%) |
|
7. How many times you should brush your teeth? |
162(54%) |
138(46%) |
256(85.3%) |
44(14.6%) |
|
8. When you should wash your hand? |
204(68%) |
96(32%) |
292(97.3%) |
8(2.6%) |
|
9. Which food is good for health? |
271(90.3%) |
29(9.6%) |
287(95.3%) |
13(4.3%) |
|
10. Which of the following is protein rich diet? |
195(65%) |
105(35%) |
250(83.3%) |
50(16.6%) |
|
11. Which food components provide nutrients? |
222(74%) |
78(26%) |
289(96.3%) |
11(3.6%) |
|
12. Which one of the following is physical activity? |
165(55%) |
135(45%) |
247(82.3%) |
53(17.6%) |
|
13. How many Traffic signals are there? |
253(84.3%) |
47(15.6%) |
296(98.6%) |
4(1.3%) |
|
14. Which of the following indicates green traffic signal? |
237(79%) |
63(21%) |
280(93.3%) |
20(6.6%) |
|
15. What is the purpose of zebra crossing? |
104(34.6%) |
196(65.3%) |
208(69.3%) |
92(30.6%) |
|
16. Which type of accidents occur in home? |
143(47.6%) |
157(52.3%) |
263(87.6%) |
37(12.3%) |
|
17. Which type of accidents occur in home? |
156(52%) |
144(48%) |
263(87.6%) |
37(12.3%) |
|
18. How many hours one should sleep? |
80(26.6%) |
220(73.3%) |
240(80%) |
60(20%) |
|
25. How to improve a healthy immune system? |
101(33.6) |
199(66.3%) |
176(58.6%) |
124(41.3%) |
In domain 1 (pre-test) showed that majority of subjects (271), (253) response correct answer in item nine, thirteen, minority (29), (47) of subjects response wrong answer in tem nine and thirteen. Whereas, in (post-test) majority of subjects (296), (297) response correct answer in item thirteen and eight, minority (4), (8) of subjects response incorrect in item thirteen and eight.
Table 2(b) Subject Related Mental Health.
|
|
Domain 2; Mental Health |
|||
|
Questions |
Pre-test |
Post-test |
||
|
Correct Answer N (%) |
Incorrect Answer N (%) |
Correct Answer N (%) |
Incorrect Answer N (%) |
|
|
19. Which is the component of mental health? |
145(48.3%) |
155(51.6%) |
255(85%) |
45(15%) |
|
20. What are the mental health activities? |
136(45.3%) |
164(54.6%) |
248(82.6%) |
52(17.3%) |
In domain 2 (pre-test) showed that majority of subjects (145) response correct answer in item nineteen, minority (155) of subject response wrong answer in tem nineteen. Whereas, in (post - test) majority of subjects (255) response correct answer in item nineteen, minority (45) of subjects response wrong answer in item nineteen.
Table 2(C) Subject Related Social Health.
|
|
Domain 3; Social Health |
|||
|
Questions |
Pre-test |
Pot-test |
||
|
Correct Answer N (%) |
Incorrect Answer N (%) |
Correct Answer N (%) |
Incorrect Answer N (%) |
|
|
21. How social health is improved? |
182(60.6%) |
118(39.3%) |
264(88%) |
36(12%) |
|
22. Which one of the following is a classroom activity? |
91(30.3%) |
209(69.6%) |
187(62.3%) |
113(37.6%) |
In domain 3 (pre-test) showed that majority of subjects (182) response correct answer in item twenty-one, minority (118) of subject response wrong answer in tem twenty-one. Whereas, in (post-test) majority of subjects (264) response correct answer in item twenty-one, minority (36) of subjects response wrong answer in item twenty-one.
Table 2(d) Subject Related Spiritual Health.
|
|
Domain 4; Spiritual Health |
|||
|
Questions |
Pre-test |
Post-test |
||
|
Correct Answer N (%) |
Incorrect Answer N (%) |
Correct Answer N (%) |
Incorrect Answer N (%) |
|
|
13. How social health is improved? |
130(43.3%) |
170(56.6%) |
155(51.6%) |
145(48.3%) |
|
24. Which one of the following is a classroom activity? |
150(50%) |
146(48.6%) |
224(74.6%) |
76(25.3%) |
In domain 4 (pre-test) showed that majority of subjects (150) response correct answer in item twenty-four, minority (146) of subject response wrong answer in tem twenty-four. Whereas, in (post-test) majority of subjects (224) response correct answer in item twenty-four, minority (76) of subject’s response wrong answer in item twenty-four.
Section- B:
Table-3: Pre-Test Level of Knowledge According to the Subjects Regarding Health Promoting Behavior N=300
|
Sr. No. |
Level of knowledge |
Scoring range |
Frequency (F) |
Percentage (%) |
|
1 |
Poor knowledge |
00-11 |
113 |
38% |
|
2 |
Average knowledge |
12-17 |
137 |
46% |
|
3 |
Good knowledge |
18-25 |
050 |
16% |
|
Total |
|
25 |
300 |
100% |
Table-3 showed that during pre-test 50(16%) subjects had good knowledge while 137(46%) subjects had average knowledge and 113(38%) subjects had poor knowledge regarding health promoting behaviour.
Figure 2: Post-test knowledge score on health promoting behaviour among children (7-12yrs.) Studying in Selected Schools of Kurali, Punjab (2020-2022)
Table 4: showed that in post test the majority of subjects i.e. 277(92%) had good knowledge while only 23(8%) subjects knowledge was average whereas none of them, had poor knowledge regarding health promoting behaviour.
|
Sr. No. |
Level of knowledge |
Scoring range |
(n) |
Percentage (%) |
|
1 |
Poor knowledge |
0-11 |
00 |
00% |
|
2 |
Average knowledge |
12-17 |
023 |
08% |
|
3 |
Good knowledge |
18-25 |
277 |
92% |
|
Total |
|
25 |
300 |
100% |
Table-5: Comparison of Pre-Test and Post-Test Knowledge Score Regarding Health Promoting Behaviour Among Children (7-12yrs.) Studying in Selected Schools of Kurali, punjab (2020-2022)
|
Sr. No. |
Test |
Mean ±SD |
Mean Difference |
t-value |
Df |
Tabledvalue |
|
1 |
Pre-test |
13.20±4.031 |
7.09 |
28.95 |
299 |
1.96 |
|
2 |
Post-test |
20.29±1.961 |
Table 5 represent comparison of pre-test mean score of the subjects was 13.2±4.031 whereas post-test score was 20.29±1.961. T test was applied. There was significant difference in pre-test and post-test score. Hence, results concluded that Health Promotion Programme on Health Promoting Behaviour was effective
Table -6: Association between socio-demographic variables of the subjects and effectiveness of health promotion programme. (N=300)
|
Socio- demographic Variable |
Categories |
Health promotion programme |
df |
Significant/ non- significant (p value) |
|||
|
Good (n) |
Average (n) |
Poor (n) |
Calculated Chi square value |
||||
|
Age |
7-8 |
12(20%) |
28(45%) |
22(35%) |
1.373 |
4 |
0.849 N.S |
|
9-10 |
10(13%) |
38(49%) |
29(38) |
||||
|
11-12 |
28(22%) |
71(56%) |
28(22%) |
||||
|
Gender |
Male |
29(17%) |
82(47%) |
63(36%) |
0.428 |
2 |
0.807 N.S |
|
Female |
21(17%) |
55(44%) |
50(39) |
||||
|
Area of residence |
Urban |
36(16%) |
99(44%) |
89(40%) |
1.608 |
2 |
0.448N.S |
|
Rural |
14(18%) |
38(50%) |
24(32%) |
||||
|
Dietary pattern |
Vegetarian |
30(16%) |
83(45%) |
71(39%) |
2.101 |
4 |
0.717N.S |
|
Non-vegetarian |
10(20%) |
24(50%) |
14(30%) |
||||
|
Eggetarian |
10(15%) |
30(44%) |
28(41%) |
||||
|
Religion |
Hindu |
35(18%) |
86(43%) |
77(39%) |
3.715 |
4 |
0.446N.S |
|
Muslim |
00(0.0%) |
00(0.0%) |
00(0.0) |
||||
|
Sikh |
15(16%) |
44(48%) |
33(36%) |
||||
|
Christian |
00(0.0%) |
07(70%) |
03(30%) |
||||
|
Other |
00(0.0%) |
0(0.0%) |
00(0.0) |
||||
|
Type of family |
Nuclear |
15(15%) |
48(47%) |
40(39%) |
0.503 |
2 |
0.778N.S |
|
Joint |
35(18%) |
89(45%) |
73(37%) |
||||
|
Education of father |
No formal education but can read and write |
02(20%) |
07(70%) |
01(10%) |
6.742 |
8 |
0.565N.S |
|
Primary |
08(17%) |
20(43%) |
19(40%) |
||||
|
Secondary |
10(20%) |
25(49%) |
16(31%) |
||||
|
Higher |
17(13%) |
56(44%) |
54(43%) |
||||
|
secondary |
|
|
|
||||
|
Graduate and above |
13(20%) |
29(45%) |
23(36%) |
||||
|
Education of mother |
No formal education but can readand write |
00(0.0%) |
00(0.0%) |
00(0.0) |
4.464 |
6 |
0.614N.S |
|
Primary |
8(20%) |
22(55%) |
10(25%0 |
||||
|
Secondary |
11(16%) |
32(47%) |
25(37%) |
||||
|
Higher |
11(13%) |
38(46%) |
33(40%) |
||||
|
secondary |
|
|
|
||||
|
Graduate and above |
20(18%) |
45(41%) |
45(41%) |
||||
|
Occupation of mother |
Government employee |
06(27%) |
07(32%) |
09(41%) |
5.403 |
6 |
0.493N.S |
|
Private employee |
06(12%) |
24(46%) |
22(42%) |
||||
|
Self employed |
02(25%) |
02(25%) |
04(50%) |
||||
|
House wife |
36(16%) |
104(48%) |
78(36%) |
||||
|
Labourer |
00(0.00%) |
00(0.00%) |
00(0.00%) |
||||
|
Occupation of father |
Government employee |
15(19%) |
38(48%) |
26(33%) |
1.539 |
6 |
0.957N.S |
|
Private employee |
22(15%) |
65(45%) |
59(40%) |
||||
|
Self employed |
09(18%) |
23(46%) |
18(36%) |
||||
|
Labourer |
04(16%) |
11(44%) |
10(40%) |
||||
Table No.6 depicts the association between the selected socio-demographic variable and effectiveness of health promotion programme. The findings revealed that there was no significant association between socio-demographical variable and effectiveness of health promotion programme as all the variables were found to be non-significant(<0.05) such as age (p=0.849), gender (p=0.807), area of residence (p=0.448), dietary pattern (p=0.717), religion (p=0.446), type of family (p=0.778), education of father (p=0.565), education of mother (p=0.614), occupation of mother (p=0.493) and occupation of father (p=0.957).
The study findings have several implications for different area such as Nursing practice, Nursing education and Nursing research which are discussed as below:
1. The nurse can educate the subjects regarding health promoting behaviour.
2. The nurse can educate the subjects to develop their skills in the preparing health teaching behavior according to health promoting behaviour.
1. The nurse can use a child-to-child method to teach children about healthy behaviours and act as a change agent.
2. The nursing personnel can organize promotion programme in hospital as well as community areas helps to increase the knowledge related health promoting behavior.
3. The nursing personnel can organize promotion programme in hospital as well as community areas helps to increase the knowledge related health promoting behavior.
4. The nursing personnel can organize promotion programme in hospital as well as community areas helps to increase the knowledge related health promoting behavior.
5. The nursing personnel can organize promotion programme in hospital as well as community areas helps to increase the knowledge related health promoting behavior.
1. Nursing research should be directed towards describing health promoting lifestyle practices among children.
2. Nursing research should be directed towards exploring the health promoting behavior such as physical, social, mental, spiritual health.
3. Nursing research should be conducted towards the practice and attitude related to health promoting behaviour.
The study will be a valuable resource for future research as the nursing profession becomes more grounded in research.
The findings revealed there was a substantial relationship between pre-test and post- test knowledge score regarding health promoting behavior. Hence, results concluded that Health Promotion Programme was found to be effective in enhancing the knowledge of school going children regarding health promoting behaviour at p<0.05.
AUTHOR CONTRIBUTION:
All the authors contribute to the work.
CONFLICTS OF INTEREST:
No conflict of interest.
ACKNOWLEDGEMENT:
We sincerely thank our faculty members of Saraswati Nursing Institute Dhainpura, Roop Nagar and the subject’s cooperation despite their busy schedules . We would like to thank God almightly and our parents for being the guiding stars in our lives.
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Received on 15.03.2026 Revised on 04.04.2026 Accepted on 23.04.2026 Published on 05.05.2026 Available online from May 09, 2026 A and V Pub J. of Nursing and Medical Res. 2026;5(2):73-79. DOI: 10.52711/jnmr.2026.15 ©A and V Publications All right reserved
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