Good health is a necessity for national development. Health promotion is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social well-being, a group must be ready to identify and to understand aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for lifestyle, not the target of living. Therefore, health promotion isn't just the responsibility of the health sector, but goes beyond healthy life-styles to well-being [1].

WHO and UNESCO are launching a brand new initiative “Making Every School a Health Promoting School” through the event and promotion of worldwide standards for Health Promoting Schools [2]. A new health program for children in government schools who suffer from critical illnesses has been announced by the Himachal Pradesh government. All children up to class 12, except children of serving or retired state and central government employees, would be covered under the school health programme. Himachal Pradesh has over 15,000 primary and higher secondary government schools with a strength of around 10 lakh students [3].

Teachers have the greatest influence on the lives of school children and are essential in every aspect of the school health programme as they can witness the effects of poor-health on child’s academic performance [4].

Need of the Study

The National Education Policy introduced in 2020, aimed to transform India’s education system by 2040. The key to achieve the goals that National Education Policy formulated is through health-promoting schools. Until now, the education system was primarily focused on streamlined degree centered education. However, the chronic diseases, nutrition and mental health-related issues are rising among students, National Education Policy is revaluating the education structure by introducing health-promoting schools [5].

Objectives

• To assess the knowledge about the Health Promotive Services among Primary School Teachers

• To develop and administer the Structured Teaching Programme on Health Promotive Services

• To evaluate the effectiveness of Structured Teaching Programme regarding Health Promotive Services among Primary School Teachers by comparing Pretest and Posttest knowledge scores

To find out the association of knowledge among the Primary School Teachers with socio demographic variables.

• Research Approach: Quantitative Research

• Research Design: Pre-Experimental Research Design

• Setting of the Study: Primary Schools of Shimla City 

• Study Duration: September 2021

• Study Population: Primary school teachers of Shimla

• Sample Size: 40 Primary school teachers

• Sampling Technique: Non Probability Convenient Sampling Technique

Informed consent/assent was taken from selected primary school teachers and confidentiality of the teachers was also maintained.

Inclusive Criteria

The teachers who are willing to participate in the study, those who are available at the time of data collection and Teachers who live in Shimla.

Exclusion Criteria

The teachers who are not willing to participate and those who are not present at the time of study.

Development of Tool

Knowledge related questionnaires (30).

Description of Tool

Section A: It deals with demographic variables such as age, gender, qualification, nature of job, teaching experience, monthly income, religion, residential area, and source of information. 

Section B: It consists of Structured Knowledge Questionnaire regarding Health Promotive Services:

Validity of Tool

By the experts in this field.

Permission

Obtained from the concerned head of the schools.

Ethical Consideration

Ethical approval was taken from the ethical committee of Sister Nivedita Govt. Nursing College, IGMC, Shimla, for conducting the pilot study as well as the final study.

Data Collection

The data was collected in the month of September 2021. The self-structured questionnaire was given to the teachers. Pre-test was conducted and thereafter structured teaching programme was administered. Post test was conducted after one week. The data was presented in the master data sheet.

Data Analysis

With appropriate statistical test in terms of frequencies, percentage, mean, standard deviation and Chi-Square test. P value of less than 0.05 was considered to be statistically significant.

With regards to the age, majority of study subjects 26 (65%) were from the age group more than 35 years, 7 (17.5%) were in >30-35 years, 5 (12.5%) were in 25-30 years and 2 (5%) study subjects were in the age group less than 25 years. As per gender, the majority of 32 (80%) of study subjects were female whereas only 8 (20%) subjects were males. As per qualification, majority 33 (82.5%) of subjects were post graduate, 5 (12.5%) subjects were graduate and 1 (2.5%) has done TTC and PhD. out of 40 subjects 24 (60%) were in Private Job and 16 (40%) were in government Job. As per the teaching experience, 15 (37.5%) samples has teaching experience more than 15 years, 9 (22.5%) subjects has teaching experience >10-15 years and equal study subjects i.e. 8 (20%) were having teaching experience 0-5 years and >5-10 years each. As per monthly income, 15 (37.5%) study subjects were having income less than 15000, 13 (32.5%) has 15001-30000 monthly income, 8 (20%) subjects has monthly income more than 45000, and only 4 (10%) study samples has 30001-45000 monthly income. As per religion majority of samples 39 (97.5%) were Hindu followed by 01 (2.5%) subjects who has opted to other religion while none subjects were Muslim, Sikh and Christian. As per residential area, majority 30 (75.5%) of subjects belongs to urban area, and only 10 (25%) belongs to rural area. As per source of information, 17 (42.5%) study subjects had information from the health personnale, 16 (40%) had knowledge from the mass media while 03 (7.5%) subjects had knowledge from the higher authority and equal study 2 (5%) subjects had knowledge from colleague and seminar.

Table 1: Frequency and Percentage Distribution of Primary School Teachers according to Demographic Variables

Table 2 depicts that in pre-test score, 7 (17.5%) had inadequate knowledge, 31 (77.5%) had moderately adequate knowledge and only 2 (5%) study sample had adequate knowledge.

Table 2: Frequency and Percentage Distribution of Pre Test Knowledge Score

The data presented in the Table 3 shows that mean value of Pre Test knowledge was 14.83, standard deviation was 4.150, median score is 15, maximum score is 22, minimum score is 05, range is 17 and mean percentage is 49.40.

Table 3: Descriptive Statistics of Pre Test Knowledge Score of Samples.

Table 4 depicts the post-test knowledge scores. None of the sample falls in inadequate knowledge. Only 10 (25%) falls in moderately adequate category and 30 (75%) were having adequate knowledge score.

Table 4: Frequency and Percentage Distribution of Post- Knowledge Scores of Samples Regarding Health Promotive Services

Table 5 shows that post-test mean score was 22.18, standard deviation was 2.438, median score was 22, maximum was 27, minimum was 17, range was 10 mean percentage was 73.90%.

Table 5: Descriptive Statistics of Post Test Level of Knowledge Scores of Samples

Data presented in the Table 6 shows that by using t-test, it was found that there is significant change in post-test knowledge scores of samples. The pre-test and post-test mean score for knowledge regarding Health Promotive Services was 14.83 and 22.18 respectively. Standard deviation for pre-test and post-test was ±4.15 and ±2.438. Range for pre-test was 5-22 and for post-test it was 17-27. Mean difference was 7.350. 

Table 6: Descriptive Statistical Findings on Effectiveness of Structured Teaching Program (Stp) Regarding Health Promotive Services

Comparison of Pre and Post Test Scores with Paired T-Test

The calculated ‘t’ value (18.105) was greater than the table value (t = 2.02) at 0.05 level of significance which shows significance.

In Table 7 the Chi-square value shows that there is significance association between the pre-test score level score with the selected socio demographic variables (Qualification). There is no significance association between the pre-test score level score with the selected socio demographic variables (age, gender, nature of job, teaching experience, monthly income, religion, residential area, and source of information) The calculated chi-square values were less than the table value at the 0.05 level of significance.

Table 7: Association of Knowledge Scores of with Selected Socio-Demographic Variables

In present study, the pre-test knowledge score 17.5% primary school teachers had average knowledge, 77.5% had moderately adequate knowledge, and only 5% primary school teachers had adequate knowledge regarding Health Promotive Services

In the present study, there is significant difference between pre-test knowledge score and post-test knowledge score after administration of Structured Teaching Programme. The mean post-test knowledge score 22.18 of the present study was higher than mean pre-test knowledge score 14.83 with the mean difference of 7.35. The difference between pre-test and post-test knowledge was statistically tested and it was found significant.

The chi-square value shows that there was a significant association between pre-test level of score with selected socio-demographic variables (qualification).

The main focus of the study was to asssess the effectiveness of Structured Teaching Programme on knowledge regarding Health Promotive Services among the Primary School Teachers in selected schools of District Shimla. Health Promotive Services is an economical and powerful means of raising community health, and more important, in future generation. The school health service is a personal health service. The teacher is not only the key person in the school health and education programme. Teachers have the greatest influence on the lives of school children and are essential in every aspect of the school health programme as they can witness the effects of poor health on child’s academic performance. So greater attention should be paid to increase the knowledge of school teachers.

1. First International Conference on Health Promotion Ottawa 21 November 1986. World Health Organization, https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference.

2. Making every school a health promoting school. World Health Organization, https://www.who.int/initiatives/making-every-school-a-health-promoting-school.

3. “Himachal Pradesh government launches new health program for school children.” Medindia, 2013, https://www.medindia.net/news/himachal-pradesh-government-launches-new-health-program-for-school-children-117675-1.htm.

4. Nair, S.S. “A study to evaluate the effectiveness of structured teaching programme on knowledge regarding health promotive services among primary school teachers in a selected school Bengaluru.” 2013, http://52.172.27.147:8080/jspui/bitstream/123456789/8992/1/Shyny%20S%20Nair%20CHN%20Brite%202013.pdf.

5. Team Octa Health. “Health-promoting schools: Reshaping India’s academia.” Octa Health, 2020, https://octahealth.in/blog/health-promoting-schools-reshaping-indias-academia/.