Most health education programs have assumed that communication of health information flows from parent to child and not the reverse. Targeting children to change parental knowledge has rarely been tested in various content areas, but the interventions have used traditional teaching methods that may not fully engage the children. We propose that utilizing children as conduits for carrying out interventions aimed at their parents has the potential to serve as the basis for intervention in any number of other areas, for example, medication adherence, healthy eating and weight loss, treatment of diabetes, and so on.
Evidence-based models that demonstrate the efficacy of health communication strategies are vital for public health education. Child-Mediated Health Interventions may represent an important vehicle for public health education because of its potential to: (1) provide public health officials with a “captive” audience in the schools, (2) improve child health literacy and risk-related behaviors, (3) utilize children’s access to their parents to influence parental health literacy and risk-related behaviors, (4) provide a low-cost, and cost-effective, alternative to expensive mass media campaigns.
Few studies have successfully shown that young children are able to initiate health communications with parents and affect parental health behavior. Open Airways for Schools (OAS)1 showed that children with asthma were able to successfully teach their parents new patterns of asthma self-management at home, and a school-based hypertension program2 showed that children might improve parents’ knowledge about hypertension and increase the likelihood the parents will consult their physician about their blood pressure. The Hip Hop Stroke™ and Hip Hop HEALS™ (Healthy Eating And Living in Schools) programs, developed by Hip Hop Public Health, utilize the Child-Mediated Health Intervention model to deliver knowledge, behavioral skills, and behavior change to children and parents. Hip Hop Stroke™ educates preadolescent children about stroke symptoms, urgent action, and stroke prevention [stroke literacy] and utilizes stroke-educated children as conduits for the delivery of stroke information to their adult caregivers at home.3 Hip Hop HEALS™ brings the concept of “purchase influence”, well-described in the marketing literature, into the healthcare arena. Purchase Influence is a term used to describe a child’s influence over parental purchasing behavior. Studies show that more than 50% of family food purchases at restaurants and grocery stores are influenced by children. Hip Hop HEALS™ delivers caloric and menu board literacy along with basic consumer literacy skills to children in order to change their own food-purchasing behavior. Using child-mediated health intervention, children are motivated to influence parental dietary decision-making at the point of purchase. Despite the promise of these studies, this public health practice model has not been developed further as evidenced by a paucity of published reports.
The following short animated feature shows the power of a child-mediated health intervention:
1. Evans D, Clark NM, Levison MJ, Levin B, Mellins RB. Can children teach their parents about asthma? Health Educ Behav. Aug 2001;28(4):500-511.
2. Viera AJ, Garrett JM. Preliminary study of a school-based program to improve hypertension awareness in the community. Fam Med. Apr 2008;40(4):264-270.
3. Williams O, DeSorbo A, Noble J. Child Mediated Intervention to increase public stroke knowledge: Findings from the Hip Hop Stroke program. 7th World Stroke Congress 2010 annual meeting.
