LAUSR

Objective: Research has shown that developing health literacy in early life is critical to reducing lifestyle-related diseases, with schools being identified as central settings for this purpose. This paper examines how one classroom-based health educational programme, IMOVE, helped Danish primary school pupils develop health literacy related to physical activity. It discusses curriculum-integrated health education’s contribution to promoting health literacy. Design: Qualitative classroom observation. Setting: IMOVE was implemented in 12 school classes (grades 5–7) in four public schools in Copenhagen, Denmark, during the autumn and winter of 2013–2014. Participants numbered 281 pupils and nine teachers. Method: We used Nutbeam’s conceptualisation of health literacy as a theoretical framework to assess which levels of health literacy the programme would promote; we assessed these using data derived from 59 IMOVE lesson transcripts. Results: IMOVE primarily contributed to the development of functional health literacy by building a relational understanding between everyday practice and step numbers. We observed the presence of interactive health literacy in discussions about how pupils and teachers could change their daily practices. Only a limited number of discussions supported the development of critical health literacy. Conclusion: Our findings suggest that educators can successfully integrate health literacy development into classroom-based curriculum teaching, with pupils’ own step counts and associated reflections positively influencing learning. However, in this study, classroom teaching was limited to a focus on cognitive skills and only partially supported the development of more critical health literacy skills. Our findings call for further research into approaches to support classroom-based critical health literacy development.