The Effects of Health Literacy Development Program with Family Participation of Overweight Primary School Students in Nakhon Pathom Province

Main Article Content

Sasitorn Roojanavech
Kannikar Chatdokmaiprai


            This quasi-experimental research used the two-group pretest-posttest design and aimed to investigate the effects of a health literacy development program with family participation for the overweight primary school students in Nakhon Pathom Province. The samples were overweight primary school students aged 9 - 12 years, selected using simple random sampling and assigned into experimental group and control group with 30 respondents each. The experimental group received the 8-week health literacy development program developed from Nutbeam’s health literacy concept and House’s social support theory, whereas the control group received the usual activity. Research instruments consisted of health literacy skill measurement and obesity preventive questionnaire. The content validity index was 1 and 0.90, respectively. The overall reliability of 6 health literacy skills before implementation was 0.82 while cognitive skill (KR-20) was 0.74. Cronbach’s alpha coefficient of access skill, communication skill, self-management skill, media literacy skill, decision-making skill, and obesity prevention were 0.88, 0.85, 0.84, 0.86, 0.78, and 0.83, respectively. Data were analyzed using descriptive statistics, independent t-test, and paired t-test.
            The results revealed that after receiving the intervention, the experimental group had significantly higher mean scores of health literacy and obesity preventive behavior than before and also when compared with the controlled group (t = -16.39, p < .001; t = 8.70, p < .001). Moreover, the experimental group had a statistically significant higher mean difference score of body weight than the control group (t = -13.45, p < .001).The research findings indicated that school nurses could apply this program to enhance health literacy and modify health behavior for weight control among overweight school-aged children.

Article Details

Research Article


World Health Organization. Childhood overweight and obesity. [Internet]. [cited 2021 August 20]. Available from: http://www.

Office of Strategy and Planning. Health Data Center (HDC) report system. [Internet]. [cited 2021 July 23]. Available from: (in Thai).

Department of Health, Ministry of Public Health. Guideline for controlling and prevention over nutrition in school age. Nonthaburi: Ministry of Public Health; 2018. (in Thai).

Sirikulchayanonta C. Obesity in school-aged children from the particle to the community. 2nd ed. Bangkok: Best Graphic Press; 2015. (in Thai).

Bureau of Policy and Strategy, Ministry of Public Health. MOPH Key Performance Index. [Internet]. [cited 2021 August 13]. Available from: php?. (in Thai).

Nutbeam D. The evolving concept of health literacy. Social Science and Medicine 2008;67(12):2072-8.

Health Education Division. Assessment of health literacy and health behavior in child and adolescents on national health recommendations. Bangkok: New Thammada Printing; 2016. (in Thai).

Poomthavorn P, Nimit-Arnun N, Roojanavech S. The effects of health literacy promoting program for overweight primary school students. Chonburi Hospital Journal 2017;42(2):171-80. (in Thai).

Phetkong C, Banchonhattakit P. Effects of health literacy promoting program with social media used on obesity prevention behavior among overweight Mattayomsuksa 2 students. Journal of Health Education 2019;42(2):23-32. (in Thai).

Chari R, Warsh J, Ketterer T, Hossain J, Sharif I. Association between health literacy and child and adolescent obesity. Patient Education and Counseling 2014;94(1):61-6.

House JS. Work stress and social support. California: Addison Wesley; 1981.

Choojan S, Thongbai W, Kummabut J. The effects of self-efficacy and family support promotion program on consumption behavior among late school aged children with overweight. Journal of Boromarajonani College of Nursing, Bangkok 2016;32(1):31-43. (in Thai).

Chaisri J, Klungtumneim K, Buajarean H. Clinical nursing practice guideline for management of obesity in children: the synthesis of thesis. Journal of the Royal Thai Army Nurses 2014;15(2):360-67. (in Thai).

Bureau of Nutrition, Department of Health, Ministry of Public Health. Manual to using height and weight criteria for assessing the growth of Thai children. Bangkok: The War Veterans Organization of Thailand; 1999. (in Thai).

Srisatidnarakul B. Effect size power analysis optimal sample size calculations using G* Power software. Bangkok: Chulalongkorn University Press; 2020. (in Thai).

Health Education Division, Behavioral Science Research Institute SWU. Health literacy scale for Thai childhood overweight. Nonthaburi: Department of Health Service Support, Ministry of Public Health; 2014. (in Thai).

Intarakamhang U. Health literacy: measurement and development. Bangkok: Behavioral Science Research Institute, Srinakarinwirot University; 2017. (in Thai).

Kompilanon K, Thamrongsotthisakul W, Vibulrangsan S. The development of curriculum to promote health literacy in obesity for Matthayomsuksa 3 students. Journal of Education Naresuan University 2016;18(3):250-64. (in Thai).

Puttapunyo S, Toontom N, Putthanachote N. Effectiveness of a health behavior development program on health literacy, weight loss behavior and w eight of overweight personnel in Roi Et hospital, Mueang district, Roi Et province. Journal of Nursing and Education 2016;9(4):42-59. (in Thai).

Pichairat A, Chansungnoen J. Effect of family role promotion program on parent’s caring behaviors for weight control in obese school-aged children in Palian district, Trang province. Journal of Southern Technology 2018;11(2):95-102. (in Thai).

No-in K. Overweight and obesity among Thai school-aged children and adolescents. Journal of the Royal Thai Army Nurses 2017;18(Suppl May - August):1-18. (in Thai).

Joyrod S, Songthap A. Family role is fundamental in overweight prevention among school children. The Southern College Network Journal of Nursing and Public Health 2019;6(2):270-8. (in Thai).

Kelishadi R, Azizi-Soleiman F. Controlling childhood obesity: a systematic review on strategies and challenges. Journal of Research in Medical Sciences 2014;19(10):993-1008.

Tuntiakarat S, Khuneepong A. The effectiveness of health behavior modification program among overweight and obesity primary school students. Journal of Nursing and Education 2019;12(1):100-16. (in Thai).

Konthongtom T, Nookong A, Sangperm P. Effects of weight control program on eating and physical activity behaviors among school-aged children with overweight. Journal of Nursing Science Chulalongkorn University 2018;30(2):28-40. (in Thai).

Jantacumma N, Manachevakul S, Cheevakasemsook A, Kaewsan P, Sanboonsong P. Effects of a school-based overweight control program on primary school students in Nonthaburi province. Royal Thai Navy Medical Journal 2020;47(2):301-16. (in Thai).