Objective Aim to explore the feasibility and preliminary impact of classroom-based and extracurricular interventions within eighth-grade biology curriculum to improve health promotion behavior (HPB) and multidimensional health of rural adolescents in China. Methods An exploratory study with two surveys was conducted at eighth-grade students in a Chinese rural middle school. The intervention combined theoretical classroom instruction with practical extracurricular activities, all embedded within the biology curriculum. Given the incomplete pairing of the two survey samples, the data were analyzed as independent samples. Statistical significance was assessed using the Chi-square test for categorical variables and the Mann–Whitney U test for continuous variables. Results Analyses indicated that the intervention was associated with significant positive outcomes. Compared with the first survey, the second had significantly higher overall HPB scores ( p = 0.006, r = 0.155). Specifically, significant increases were observed in exercise behavior ( p 0.001, r = 0.231) and health responsibility ( p = 0.004, r = 0.162). Additionally, the second survey group reported significantly better outcomes across multidimensional health, including self-reported health ( p = 0.030, r = 0.121), physical health ( p = 0.003, r = 0.167), and mental health ( p = 0.009, r = 0.146). Subgroup analyses across both survey time points further revealed that the HPB-high group consistently scored significantly higher than the HPB-low group across all three health dimensions (all p 0.001, r ≥ 0.460). Conclusion This exploratory study confirmed the feasibility of classroom-based and extracurricular intervention and its potential to improve adolescent health. The observed correlation between high HPB and better health outcomes only suggests an association and the need for targeted support. Our findings recommend a collaborative model in which educators and health professionals jointly develop and implement interventions to advance the holistic development of rural adolescents.
Chen et al. (2026) studied this question.