Health literacy enhancement through food guide and hygiene education: a study among Taiwanese students

The World Health Organization defined health as 'a condition of full physical, mental and social well-being'. Nutrition and food safety are intertwined and two of the most influential determinants of human health. This study primarily aimed to design and implement a specialized curriculum focused on food hygiene, and Taiwan's daily food guide to enhance health literacy among junior high students in Taiwan. A student-centered approach, based on active learning and constructivist principles, was used to engage students in interactive discussions and hands-on activities related to dietary guidelines and food hygiene. Four classrooms, with a total of 92 students, participated in this study. The students were randomized into a control group (n = 46) and an experimental group (n = 46). The average age ranged from 13 to 15 years. An illustrated questionnaire underwent pilot testing and expert review, followed by pre- and post-intervention assessments to measure knowledge improvements. The results showed a significant connection between the Taiwan daily food guide and health literacy. Although food hygiene education played a lesser role, the intervention improved students' health literacy, supporting positive health outcomes. In addition, recognizing the lack of suitable assessment tools in this field, we developed a reliable and valid illustrated questionnaire to measure the effectiveness of the intervention and track changes in students' knowledge. The questionnaire demonstrated high internal consistency (Cronbach's alpha of 0.883) and strong inter-rater reliability (intraclass correlation factor above 0.7), confirming its effectiveness as a tool for educational research.