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Democratic school health education in a post-communist country

Zuzana Boberova (Department of Natural Sciences and Technological Disciplines, University of Presov, Presov, Slovakia)
Leena Paakkari (Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland)
Ivan Ropovik (Department of Preschool and Elementary Education and Psychology, University of Presov, Presov, Slovakia)
Jozef Liba (Department of Natural Sciences and Technological Disciplines, University of Presov, Presov, Slovakia)

Health Education

ISSN: 0965-4283

Article publication date: 7 August 2017



The purpose of this paper is to discuss the findings of an intervention program built on the concept of children’s health literacy, particularly on its citizenship component. This intervention program employed the Investigation-Vision-Action-Change model for action-oriented teaching, where children were supported to investigate different health issues that affect them, create visions about desirable changes, and act toward desirable change. The intervention was implemented in the conditions of a post-communist country (Slovakia) where the majority of health education programs are behaviorally oriented, without giving space to children’s own perceptions and decisions. The study seeks to explore whether fostering children’s participation in forming the school environment improves the three selected factors of school well-being, namely, children’s perception of school, their subjective well-being, and violent behavior in school.


A cluster-randomized controlled trial design was used where ten classes of children aged nine to ten years were randomly assigned to either experimental (n=89) or control group (n=96). The dependent variables were pre- and post-tested using measures drawn from the Health Behavior in School-aged Children study for Slovakia.


The intervention program was shown to yield empirically robust effects, given the significant improvement in children’s perceptions about school, violent behavior, and their well-being, with medium-to-large effect sizes (Hedges’s g ranging from 0.74 to 0.96).


The present study offers an effective approach to enhance the respect for the children’s views on issues that affect them, particularly within post-communist conditions.



Boberova, Z., Paakkari, L., Ropovik, I. and Liba, J. (2017), "Democratic school health education in a post-communist country", Health Education, Vol. 117 No. 5, pp. 469-484.



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