A community-based health education program: effects and differences in health literacy and self-efficacy across demographic and health variables among Haitians

Purpose The study aims to examine differences in health literacy and self-efficacy scores by demographics, individual resources and health variables and the changes in health literacy and self-efficacy scores following health education intervention among Haitian immigrants. Design/methodology/approach Eight community-based health presentations were conducted during 2022–2023. Health literacy was assessed using 20 questions pre-post education intervention and at 6-month follow up. Self-efficacy for nutrition and physical activity using five-item scales were evaluated at baseline and six months. A convenience sample included 156 and 56 Haitians at baseline and six-month follow-up. T-tests were used to examine pre-post-intervention scores and ANOVA to examine differences between groups. Findings There was a statistically significant increase in health literacy (8.5 ± 3.4) after health education (10.2 ± 3.4; p < 0.001) but no significant improvement at six-month follow-up. Health literacy was significantly higher for older adults at six months (p 0.027). There was no significant improvement in either nutrition or physical activity self-efficacy at six-month follow-up. However, nutrition self-efficacy at baseline was significantly higher for those with lower body mass index (p 0.042) and at six-months, higher among those with higher educational levels (p 0.037) but lowest for the retired (p 0.035). Physical activity self-efficacy scores at baseline were significantly lower for the retired (p 0.003) but higher among those who self-reported to be diabetic (p 0.048). Research limitations/implications Low health literacy before intervention and significant increase after educational intervention indicate the need for community-based health education activities, especially for those with low educational levels and retirees. However, health education alone does not improve self-efficacy. Future studies should investigate contextual and ecological factors affecting health-specific self-efficacy in Haitians. Minimal increase in health literacy in certain demographic and health-related categories as demonstrated in the study highlights the importance of investigating barriers to health literacy in those subgroups. Originality/value This study discusses the findings of an exploratory study and outreach program conducted among the Haitian population in SWFL. Utilizing RTI’s Health Literacy Skill framework, the study offers empirical evidence on the differences in health literacy and self-efficacy levels across individual characteristics-demographic variables, resources and investigates changes in health literacy and lifestyle self-efficacy (nutrition and physical activity) following brief health education intervention among Haitian immigrants.