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Promotion of Influenza Prevention Beliefs and Behaviors Through Primary School Science Education

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Promotion of Influenza Prevention Beliefs and Behaviors Through Primary School Science Education

T H Koep et al. J Community Med Health Educ.

Abstract

Background: School-based campaigns to improve student health have demonstrated short-term success across various health topics. However, evidence of the effectiveness of programs in promoting healthy beliefs and behaviors is limited. We hypothesized that educational curricula teaching the science behind health promotion would increase student knowledge, beliefs and adherence to healthy behaviors, in this case related to influenza.

Methods: Integrated Science Education Outreach is a successful education intervention in Rochester, Minnesota public schools that has demonstrated improvements in student learning. Within this program, we designed novel curricula and assessments to determine if gains in knowledge extended to influenza prevention. Further, we coupled InSciEd Out programming with a clinical intervention, Influenza Prevention Prescription Education (IPPE), to compare students' attitudes, intentions and healthy behaviors utilizing surveys and hand hygiene monitoring equipment.

Results: 95 students participated in (IPPE) in the intervention school. Talking drawings captured improvement in influenza prevention understanding related to hand washing [pre n=17(43%); post n=30(77%)] and vaccination [pre n=2(5%); post n=15(38%)]. Findings from 1024 surveys from 566 students revealed strong baseline understanding and attitudes related to hand washing and cough etiquette (74% or greater positive responses). Automated hand hygiene monitoring in school bathrooms and classrooms estimated compliance for both soap (overall median 63%, IQR 38% to 100%) and hand sanitizer use (0.04 to 0.24 uses per student per day) but did not show significant pre/ post IPPE differences.

Conclusions: Student understanding of principles of influenza prevention was reasonably high. Even with this baseline, InSciEd Out and IPPE improved students' unprompted knowledge of behaviors to prevent influenza, as reflected by talking drawings. This novel metric may be more sensitive in capturing knowledge among students than traditional assessment methods. However, IPPE did not produce further significant differences in student attitudes and behaviors regarding the flu.

Keywords: Child health; Community health; Health behavior; Influenza; Science education.

Figures

Figure 1
Figure 1
Prescription education: Health beliefs and assessments; Prescription Education measures student changes in knowledge, attitudes, and behavior regarding relevant health topics pre and post curriculum. Various assessments, such as talking drawings, surveys, and focus groups, are utilized to assess different health determinant domains.
Figure 2
Figure 2
Student influenza prevention understanding pre/post curriculum; Representative drawings from a single 4th grade student in Intervention School, Year 1 pre and post-curriculum intervention, in response to the question, “What does is mean to be healthy?”.
Figure 3
Figure 3
Health concepts in talking drawings; Comparison of year 1 pre-curricula and year 1 post-curricula concepts on student talking drawings, where each count represents use on an individual drawing. Concepts were selected prior to the study period from candidate influenza prevention strategies and grade-specific science standards.
Figure 4
Figure 4
Early language of how to stay healthy; Classroom analysis of words and phrases appearing on pre- and post- curriculum talking drawings in 4th grade, Year 1, as depicted in a word cloud. Word size is proportional to frequency of usage, with larger word size correlating to higher frequency of use.
Figure 5
Figure 5
Hand hygiene (soap and hand sanitizer) compliance in intervention and control school; Hand sanitizer dispenser data from main hallway entry into all 3rd and 4th grade classrooms at both Intervention and Control Schools; A) August 18, 2013-April 11, 2014 hand sanitizer use in 3rd and 4th grade classrooms; Control school, Year 2; B) August 18, 2013-March 20, 2014 hand sanitizer usage in 3rd and 4th grade classrooms; Intervention school, Year 2. Intervention dates in each grade were non-overlapping and comprised 4-6 weeks within total study interval.

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