Effectiveness of a Novel School-Based Diabetes Prevention Program: A Post-Implementation Analysis of Arogya World Healthy Schools Program, India, 2015-2022

Introduction: Non-communicable diseases pose significant health challenges worldwide, particularly in low- and middle-income countries like India, where diabetes mellitus is on an alarming rise, especially among youth. The global health non-profit Aro­gya World created the Healthy Schools program (HSP), a 2-year, school-based initiative for Grades 6–8 targeting diabetes prevention through peer-led health literacy and lifestyle modification. The program was implemented across 18 states and over 7,500 schools, reaching nearly 450,000 students across rural and urban India. Methods: This study evaluated the intervention’s effectiveness in enhancing diabetes-related knowledge, attitudes, and prac­tices among students participating in Arogya World’s HSP across 18 states and over 7,500 schools. Previous sampling of 6,616 students aged 11–15 years using Knowledge, Attitude, and Practice questionnaires provided pre- and post-2-year data for each year of the intervention. The present study expanded on the prior study with a post-implementation, quasi-exper­imental analysis of the data that had been collected during 2015–2022. Changes in knowledge, dietary patterns, and physical activity levels were evaluated using descriptive statistics and mixed-effects regression. Results: Overall knowledge scores improved by 15.9% with gains in nutrition (14.6%), physical activity (13.1%), and diabetes awareness (24.5%) [P < 0.01]. With respect to behavior change, healthy food consumption improved by 7.4% and physical activity increased by 10.1% (P < 0.01). Conclusion: Analysis of program data during 2015–2022 indicated that the implementation of a low-cost, scalable health education program using a school-based, peer-led model for diabetes prevention affected knowledge and behavior change among a group of adolescent students participating in the HSP. Study limitations included the absence of a control group. These results could inform similar school-based programs in their efforts to curb the diabetes crisis among youth worldwide.