Abstract

Abstract Background School-based health literacy interventions have the potential to significantly impact the health of disadvantaged youth. However, the effectiveness of such interventions varies. The aim of the ‘health literacy among youth’-intervention was to improve the health literacy of disadvantaged youth in two school settings in Denmark. Methods The intervention began with identifying the health literacy needs of 128 students. Groups of teachers from each school participated in workshops facilitated by the research team to develop activities to address the specific needs of the students. Over the course of one school year (August 2023 to May 2024), these activities were implemented. Questionnaires were administered to students before, during, and after the intervention, and semi-structured interviews were conducted among teachers and students. Results Teachers at each school created activities aligned with the organizational structure and the needs of the students, focusing on occupational diseases and injuries, and physical activity and mental well-being, respectively. However, contextual factors such as time constraints, students’ characteristics, and teachers’ professional backgrounds and varying levels of motivation, influenced the implementation. Conclusions The intervention design offered flexibility in tailoring health literacy activities and their implementation to suit the unique contexts of the two schools. While the participatory approach facilitated targeted and organizationally aligned health interventions, its feasibility varied across contexts. Our findings highlight the importance of involving participants in developing health interventions to ensure relevance and alignment with specific needs of the target group. Key messages • Despite contextual similarities, the outcome of participatory intervention approaches may vary across contexts. • Co-creation contribute to health literacy interventions that are tailored the needs of the target group.

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