Abstract
BackgroundAlthough multifaceted community-based programmes have been widely developed, there remains a paucity of evaluation of the effectiveness of multifaceted injury prevention programmes implemented in different settings in the community context. This study was to provide information for the evaluation of community-based health education programmes of injury prevention among high school students.MethodsThe pre-intervention survey was conducted in November 2009. Health belief model (HBM) based health education for injury prevention started in January 2010 and stopped in the end of 2011 among high school students in the community context in Shanghai, China. A post-intervention survey was conducted six weeks after the completion of intervention. Injury-related health belief indicators were captured by a short questionnaire before and after the intervention. Health belief scores were calculated and compared using the simple sum score (SSS) method and the confirmatory factor analysis weighted score (CFAWS) method, respectively.ResultsThe average reliability coefficient for the questionnaire was 0.89. The factor structure of HBM was given and the data fit HBM in the confirmatory factor analysis (CFA) very well. The result of CFA showed that Perceived Benefits of Taking Action (BEN) and Perceived Seriousness (SER) had the greatest impact on the health belief, Perceived Susceptibility (SUS) and Cues to Action (CTA) were the second and third most important components of HBM respectively. Barriers to Taking Action (BAR) had no notable impact on HBM. The standardized path coefficient was only 0.35, with only a small impact on CTA. The health belief score was significantly higher after intervention (p < 0.001), which was similar in the CFAWS method and in the SSS method. However, the 95% confidential interval in the CFAWS method was narrower than that in the SSS method.ConclusionsThe results of CFA provide further empirical support for the HBM in injury intervention. The CFAWS method can be used to calculate the health belief scores and evaluate the injury related intervention. The community-based school health education might improve injury-related health belief among high school students; however, this preliminary observation needs to be confirmed in further research.
Highlights
Multifaceted community-based programmes have been widely developed, there remains a paucity of evaluation of the effectiveness of multifaceted injury prevention programmes implemented in different settings in the community context
Reliability test of the questionnaire The result of the questionnaire reliability test showed that reliability coefficients (Cronbach’s alpha) ranged from 0.89 to 0.94 for the five parts (SUS, SER, Benefits of Taking Action (BEN), Barriers to Taking Action (BAR), Cues to Action (CTA)), and the average reliability coefficient was 0.89 for the 22 items
The result of confirmatory factor analysis (CFA) showed that BEN and SER had the greatest impact on the health belief, SUS and CTA were the second and third most important components of Health belief model (HBM) respectively
Summary
Multifaceted community-based programmes have been widely developed, there remains a paucity of evaluation of the effectiveness of multifaceted injury prevention programmes implemented in different settings in the community context. This study was to provide information for the evaluation of community-based health education programmes of injury prevention among high school students. During the last 25 years, multifaceted communitybased programmes have become an important approach to promote health and prevent injuries [5,6]. This approach emphasizes the importance of community member participation and multidisciplinary collaboration among local organizations [5,7]. Health education is the indispensable content of a multifaceted community-based injury intervention programme and is effective for injury control among pupils and middle school students [8]. School and family make a combined effort to provide health education to students
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