Leveraging community engagement to increase the health literacy of youth in rural Pennsylvania: The ACHIEVE program

Purpose: Limited health literacy is prevalent within rural populations and associated with poor health outcomes. This study examined a school-based, community-engaged program called ACHIEVE (Advancing Community Health Innovation through Education, Vision, and Empowerment) for preliminary efficacy in improving knowledge and self-efficacy related to health literacy among youth in rural Huntingdon County, Pennsylvania. Methods: ACHIEVE was designed using an iterative process that utilized validated sources, educational standards, and community engagement. Five novel health literacy modules were piloted by the program in Huntingdon Area High School and delivered to ∼269 students during the 2019-2020 and 2020-2021 school years. To determine the impact of the program, we assessed participants’ change in health knowledge and self-efficacy using pre- and post-tests for each module. Responses were collected via anonymous surveys and analyzed using unequal variance t-tests and chi-square tests. Findings: The overall mean difference between pre- and post-tests ranged from 0.07 to 0.67, with a significant increase in participants’ assessment scores following 4 out of the 5 program modules (P <.05). Across the 5 modules, both knowledge and self-efficacy domains displayed a significant improvement from pre- to post-test (P <.001). Conclusion: Our findings suggest that community partnerships in rural communities can be used to create effective community health interventions, such as our health literacy program, which significantly increased high school students’ knowledge and self-efficacy.