Effects of Active Learning on Health Literacy and Behavior in Older Adults: A Randomized Controlled Trial

OBJECTIVES To investigate the effects of active learning education on health literacy, cognitive and physical function, physical activity, and dietary habits in older adults. DESIGN Randomized controlled trial. SETTING Rural community in Japan. PARTICIPANTS Individuals aged 65 and older (N=84) randomly assigned to a health education intervention group (n=42) or a control group (n=42). INTERVENTION The intervention group attended a weekly 90‐minute active learning program on exercise, diet and nutrition, and cognitive activity for health promotion in older age for 24 weeks. Active learning included exploratory learning, group work, and self‐planning for behavioral change, which promoted a healthy lifestyle. MEASUREMENTS Outcome measures were obtained at baseline before randomization and at 24 weeks. Comprehensive health literacy was assessed as the primary outcome using the Health Literacy Scale‐14 (HLS‐14) and the 16‐item European Health Literacy Survey Questionnaire (HLS‐EU‐Q16). Cognitive function was evaluated in 4 domains: processing speed, verbal fluency, working memory, and memory. Physical function and amounts of physical activity were also objectively measured. RESULTS HLS‐14, the disease prevention domain of the HLS‐EU‐Q16, category verbal fluency test, Scenery Picture Memory Test, and Timed Up and Go test scores; gait speed; number of steps per day; physical activity levels; and dietary variety scores were significantly improved in the intervention group than the control group. CONCLUSION This study suggests that health education through active learning is effective in enhancing comprehensive health literacy, verbal fluency, memory, gait speed, balance ability, physical activity, and dietary variety in older adults.