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Background This communication aims to study the impact of a co-design process involving teachers in the creation of a health education tool for elementary school (a &amp;lt;&amp;lt; continuous design in use &amp;gt;&amp;gt; device). Indeed, the simple dissemination of a tool is not enough to make practices evolve and become more effective. Teachers find it difficult to integrate a tool into their daily practices. It therefore appears necessary for teachers to be involved throughout the process of designing the tool and trained so that they feel competent and effective in its use in the classroom. Methods Within the framework of the public health plan of New Caledonia, a pedagogical tool for all elementary schools in the archipelago has been developed in 2018 and 2019. The tool has been made with the teachers and not only for the teachers. This research focused on the impact of the program. 40 schools with 102 teachers and 15 school principals were involved. Qualitative and quantitative approaches made possible the analysis of the teaching practices (classroom activities, usability, usefulness and acceptability of resources). Results 60% of the teachers were involved in the co-creation process. 272 feedbacks were collected providing 817 comments on the implementation of the proposed activities. The majority of the teachers found it relevant, of high quality and adapted to the context of the exercise. Conclusions It emerges from our analysis that the involvement of teachers in a program of &amp;lt;&amp;lt; continuous design in use &amp;gt;&amp;gt; favours the appropriation and use of a health education tool in teachers' practices. This has made it possible to shed light on the realities in the field according to the means and places of practice but also to enrich the tool in terms of shared resources and pedagogical practices. Key messages A co-design process of creation of a health education tool is a relevant mean to generate a deep involvement of primary school teachers. Such a design led to the creation of tool recognized by education professionals as being usable, useful and acceptable.

Teachers involvement in a co-design process of creation of a health education tool