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An arts-based public health literacy program boosts teens’ health knowledge and civic engagement

The COVID-19 pandemic highlighted and exacerbated health inequities. Yet the crisis also provided an opportunity to reframe how we talk and engage with youth around health and disease risk. That’s exactly what an online version of a teen-focused, arts-based, spoken word public health literacy campaign called The Bigger Picture (TBP) set out to do.

The TBP program was originally conceived in 2013 to expand awareness of type 2 diabetes by moving the focus from individual behaviors to a more public health-centered approach, which highlighted the social and environmental factors that contribute to disease risk and determine its unequal distribution across society.

“I think The Bigger Picture was so successful because it went beyond traditional youth-targeted health education campaigns and encouraged social action (rather than focusing on individual behavior change),” Berkeley Public Health Assistant Research Professor Hannah Thompson said. “[TBP] used art and poetry as means of connecting with students about public health and health equity issues that were immediate and relevant to them.”

While schools were operating online during the COVID-19 pandemic, TBP—created in partnership between the San Francisco–based nonprofit Youth Speaks and UCSF’s Center for Vulnerable Populations—was expanded to cover other ”urgent public health topics that had grown in visibility, such as COVID-19, climate change, police brutality, and mental illness” and offered online.

A group of researchers led by Dr. Thompson set out to determine the impact of the expanded online TBP program on predominantly low-income and highly diverse student populations, assessing how the program impacted students at six high schools in the San Francisco Unified School District. Their research was published in the Oct. 2022 issue of the Journal of Health Communications.

Findings from their mixed-methods study suggest that TBP, offered in an online space, can advance a culture of health in the public high school setting. After exposure to the TBP curriculum, students better understood the structural factors that affect health than students who participated in Youth Speaks traditional (not health-oriented) programming.

Online survey results showed that students who experienced the TBP curriculum had more knowledge about the causes of Type 2 diabetes and reported significantly more robust civic engagement (i.e., collecting signatures on a petition or asking people about their opinions on community health).

The results suggest that using a virtual program like TBP can advance a culture of health in a public high school setting, specifically engaging students in the structural, social, and environmental determinants of health and health equity.

“There are a lot of important lessons learned from this engaged pedagogical approach that could be applied to future health education programs for youth, particularly if classes are to be taught online,” Thompson said.

Co-authors include Hannah R. Thompson, Jackie Mendelson, and Maya Zamek of UC Berkeley; Gabriel Cortez of Youth Speaks; and Dean Schillinger of the UCSF Division of General Internal Medicine and Center for Vulnerable Populations.