Strategies to improve health literacy among teachers, parents and students: A documentary analysis of 50 school medicine policies in England

Background: Building skills in medicines use in early life is an important component of health literacy, and an investment for the health of future populations. Moreover, data from the 2022 Health Behaviour in School-Aged Children (HBSC) study indicate that 25% of students in England aged 11-15 report a long-term condition, and 35% of those students said it affects their school attendance/participation, which could involve sub-optimal medicines and condition management. Every school in England must have a policy to support students with a medical condition under statutory guidance issued by the Department for Education (issued in 2014, and updated in 2017), which includes a template. School medicine policies have the potential to promote health literacy.

Objective: To explore the content of school medicine policies regarding staff training and whole-school awareness about health and medicines, as strategies to build health literacy.

Method: This was a group project involving sixpharmacy students in 2022. Each student was assigned 1-2 of the nineregions of England; they used search engines to find school websites with publicly accessible medicine policies. Purposive sampling within each region sought diversity of schools (e.g. nursery age to college; urban and suburban; public and private/fee-paying). The group collectively developed an online data collection form for consistent, directed content analysis of the policies. This included 2 questions about the presence of content relating to staff training, and about whole-school awareness, related to health and medicines. The presence of such information was categorised as (1) Yes –a lot of information; (2) Yes –it is mentioned; or (3) None. Data from the online form for each policy were downloaded into a common Excel® spreadsheet and subjected to descriptive statistical analysis. No ethical approval was needed to analyse these public documents.

Results: The students analysed 50 school medicine policies across England (3 East Midlands; 1 East of England; 8 London; 7 North East; 8 North West; 10 South East; 4 South West; 4 West Midlands; 5 Yorkshire & Humber). Most policies included information about commitment to staff training (A lot of information = 58%; Mentioned = 32%; None = 10%). Content about whole-school awareness was less extensive, but still present in most cases (A lot of information = 30%; Mentioned = 40%; None = 30%).

Conclusion: School medicine policies may contain health literacy-building strategies. Limitations were that this was a relatively small sample of schools, and that stating an intent does not mean that it is actioned. Having the policy, however, is the start of a journey. Pharmacists should engage with local schools to find out more about their medicines policy, and whether they can contribute to staff training and whole-school awareness strategies to build health literacy within the school community, including parents. This can be reinforced in the local community pharmacy when local families visit for help and advice.

Acknowledgements: Dr Gray would like to thank the students who took part in this project: Mariam Al-Sallami, Charlotte Cunningham, Maream Hadi, Nikola Janowska, Marinela Lazri, and Farah Saleem.