Remote Implementation of a Health Promotion Program in an Underserved High School during COVID-19: Lessons Learned

Abstract

Background: This study examined the impact of remote implementation of a school-based health promotion program on health beliefs and behaviors of adolescent participants from an underserved high school during the COVID-19 pandemic. Methods: As part of the program, Family Medicine residents trained healthy 10th grade high school students from a vulnerable community in California to become health coaches for family members with diabetes. Five of eight onehour weekly sessions were delivered remotely after shelter in place was mandated. Students completed online pre and post-participation surveys including questions on health beliefs and behaviors and experience with remote learning. We explored factors associated with the likelihood of attending the remote classes, and we used paired T-tests to compare pre-and post-scores of health beliefs and behaviors, and qualitative analysis of open-ended questions to assess differences between those who completed in person sessions only and those who attended remote sessions. Results: 45 participants completed pre-surveys and 26 of those completed postsurveys. 14 of those 26 attended remote program sessions. The 14 who attended the additional remote sessions demonstrated significant improvements in health mindsets (belief that body has self-healing properties p=.045; belief that illness is an opportunity p=.028); consumption of fruits and vegetables (p=.054); consumption of sugary drinks (p=.047); understanding of how to improve their health (p=.055); and frequency of talking about health with their families (p=.057). Participants who did not attend remote sessions did not show significant improvements in these areas. Non-attendees were more likely to be Hispanic and male. Conclusions: These findings suggest that remote health promotion programs could support the health and well-being of adolescents in underserved communities. Yet, more research is essential to ensure all adolescents can participate.