Arts-Based Approach to Improve Children’s Knowledge of Hypertension and Diabetes in Addis Ababa, Ethiopia
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Date
2025-08
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Addis Ababa University
Abstract
Background: Non-communicable diseases (NCDs) are a global public health challenge. In Ethiopia, NCDs accounted for 46% of total deaths in 2023. Despite this burden, inadequate knowledge about NCDs contributes to late diagnosis and poor treatment outcomes. Although effective health education intervention is believed to improve early diagnosis and treatment of NCDs, there is limitation in reaching to the public with appropriate information and channel. This study aims to bridge this gap by evaluating the effectiveness of storybooks as a health education tool to improve knowledge about hypertension and diabetes among school children, while also exploring areas of improvement of the storybooks.
Methods: This study employed a sequential mixed method design. The study was conducted from January 2025 to March 2025 in two primary schools in Nifas Silk Lafto sub-city, Addis Ababa. For quantitative part, pre-post study design was conducted with 449 randomly selected students aged 12-19 years. Self-administered structured questionnaire was adapted from previously published research and used to measure the knowledge of children regarding hypertension and diabetes before and after disseminating the storybooks. The data were entered in to Epi-Data version 3.1 and analyzed using SPSS version 26. Paired t-test was used to compare the mean knowledge score of children before and after the intervention. A p-value less 0.05 considered statistically significant. For qualitative part, eight focus group discussions were conducted to explore areas of storybook improvement. The data were transcribed verbatim, translated in to English and coded, then thematic analysis was done, which was facilitated by MAXQDA-24.
Result: The overall mean knowledge score increased from 10.41 ± 5.50 to 14.48 ± 5.24 for hypertension and 12.02 ±5.19 to 14.32 ±4.84 for diabetes at end-line (P < 0.001). Knowledge gain was varied significantly by grade level (P = 0.025). The key areas for improvement of the storybooks that children suggested include simplifying the vocabulary, enhancing visual quality with brighter images, larger fonts, and increased line spacing as well as including more detailed health information.
Conclusion: Storybooks are an effective tool for improving children’s knowledge of hypertension and diabetes. Health messages should be presented in simple, easily understandable and visually attractive way. Future interventions should focus on refining these storybooks and expanding their distribution to improve health outcomes.
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Keywords
Arts-based approaches, School children, Knowledge, Hypertension, Diabetes