Little Health Heroes: A Mixed Methods Study on the Feasibility, Fidelity, and Efficacy of a Pilot Health Education Program in Abeokuta, Nigeria

Abstract

This study evaluates the feasibility, fidelity, and efficacy of an arts-based health education program implemented at LawNet International School in Abeokuta, Nigeria. The program integrated creative and interactive teaching methods including music, dance, storytelling, and visual arts to deliver instruction across three core modules: internal illness and prevention, mental health and emotional well-being, and physical health and nutrition. Using a mixed-methods approach, data were collected through some pre- and post-program assessments, unit-based evaluations, post-program satisfaction surveys, observational field notes, and key informant interviews. Findings indicate that the program was feasible within the school setting, as demonstrated by successful completion, high levels of learner engagement, and positive learner-reported satisfaction. Fidelity was maintained at the level of core program components, although adaptations to lesson structure and timing were required due to logistical and contextual constraints. Evidence of efficacy was mixed but promising. Quantitative results suggested patterns of improvement in health knowledge across instructional units, though variability in sample size and assessment structure limited the strength of these conclusions. Qualitative findings provided additional insight, revealing improvements in learners’ emotional awareness and expression, as well as the development of more holistic understandings of health. Health-related behavioral changes were observed but were often context-dependent and not consistently sustained outside the classroom environment, highlighting the influence of structural factors on health-related practices. Overall, this study demonstrates the potential of arts-based approaches to enhance engagement and support multidimensional learning in health education. While findings are context-specific and not generalizable, they offer valuable insights for the design, implementation, and refinement of school-based health interventions in similar settings.