Objective To compare the differences in effects of video-based intervention and paper propaganda intervention on health literacy among primary school students, and to explore the intervention method to improve the health literacy level of primary school students.

Methods Primary school students from grade 3 to 5 who had not received a health literacy survey from two schools in Zhen'an district, Dandong city were chosen by cluster sampling in November to Delember, 2023. They were recruited and given the video-based intervention (n=355) or paper propaganda intervention (n=301) for 2 months. The same questionnaire was used to conduct a health literacy survey before and after intervention. The multiple linear regression model was established by the difference-in-difference method to compare the net effect of the two intervention methods on overall health literacy level of primary school students.

Results The overall health literacy levels were 88.3% and 93.2% after paper propaganda intervention and video-based intervention, respectively, which were significantly higher than the baseline levels (68.4% and 81.7%, P < 0.05). Compared with the video-based intervention group, the overall health literacy level and the basic behavior and skill literacy levels in the paper propaganda intervention group were significantly improved, which were increased by 2.5% and 6.2%, respectively.

Conclusion Paper propaganda intervention has a more significant effect on the improvement of health literacy level of primary school students compared with video-based intervention.