Community-based Health Education Intervention Research Articles

W193 Feasibility of community-based health education intervention to control non-communication diseases in Bangladesh: An implementation research

W193 Feasibility of community-based health education intervention to control non-communication diseases in Bangladesh: An implementation research

Impact of a community-based health education intervention on awareness of influenza, pneumonia, and vaccination intention in chronic patients

ABSTRACT The study aimed to examine the impact of a community-based health education intervention on the awareness and attitude of influenza and Streptococcus pneumoniae vaccination in patients with chronic diseases. We selected study participants from two counties in Jiaxing City, Zhejiang Province. We conducted a household baseline survey with quarterly follow-up and health education for all chronic disease patients in the area. A total of 720 patients with chronic diseases were included in two rounds of questionnaire surveys before and after a year-long health education related to the influenza and Streptococcus pneumoniae vaccination. Before the community education, 59.9% and 59.6% of study participants self-report the awareness of the hazards of influenza and pneumonia, respectively; while only 17.7% and 6.0% study participants self-reported awareness of the influenza or pneumonia vaccination, respectively; the self-reported vaccination rates were 1.3% and 0% for influenza and pneumonia, respectively. One year after the intervention, all rates were increased significantly, but the influenza vaccination rate was still far below the WHO minimum target level (75%). The main reason for not getting vaccinated reported by study participants was that participants thought they were in good health and would not become sick easily. There was no statistically significant difference between the impacts of health care practitioners’ and general practitioners’ recommendations for vaccination. Continued and pertinent health education has a significant impact on influenza and pneumonia vaccination in patients with chronic diseases.

Effects of a community-based health education intervention on eye health literacy of adults in Vietnam

ABSTRACT Health education interventions are more commonly evaluated in hospitals or schools but rarely in the community. The purpose of this study was to assess the effects of a community-based eye health education intervention on the eye health literacy in an adult Vietnamese population. Four hundred households from two districts of Ba Ria-Vung Tau province were selected by multistage systematic random sampling. A pretested questionnaire was administered at baseline and re-administered, after an eye health education intervention in two of the four communes. The other two communes acted as controls. The intervention included eye health education through community presentation, brochures, posters and loudspeaker. Fisher’s exact test and logistic regression were used for statistical analysis. A total of 400 adults (mean age: 51.5 ± 14.5 years; range, 30–90 years) participated in the baseline survey and the repeat survey. Participants in the intervention group showed significantly greater awareness and knowledge of red eye preventive measures (Odds ratio range 2.1 to 4.1, p = 0.03 to 0.001) compared to control group. Participants in the intervention group were more than twice as likely to have heard of cataract (OR 2.3, p = 0.008), and more than three times as likely to be aware of cataract surgery (OR 3.1, p = 0.003) and know that the cataract blindness is reversible (OR 3.3, p = 0.002), than the control group. Multiple logistic regression showed that location, education, and eyeglasses ownership were the major factors associated with disease awareness. The eye health education intervention successfully increased awareness and knowledge of red eye and cataract in the intervention community.

The impact of a 6-week community-based physical activity and health education intervention-a pilot study among Irish farmers.

There is a higher prevalence of lifestyle-related diseases among Irish farmers than the general adult population. Lifestyle interventions that increase physical activity and improve dietary patterns have been associated with reduced chronic disease risk and improved quality of life among high-risk populations. The impact of lifestyle interventions among Irish farmers is unknown. To assess the effectiveness of a community-based intervention on farmer health, cardiovascular fitness, lower limb strength endurance, and dietary intake. A 6-week physical activity and lifestyle education intervention involving two 60-min circuit-based exercise training sessions and one 60-min health education workshop per week was implemented. Pre- and post-measurements included total body weight, body fat percentage, lean muscle mass, resting blood pressure, fasting blood glucose, cholesterol, triglycerides, cardiovascular fitness, lower limb strength, perceived physical and mental health, and dietary intake. Thirty farmers completed the intervention giving an adherence rate of 75%. At baseline, mean BMI (32.7 ± 4.1 kg/m2), body fat percent (31.7 ± 6.7), waist circumference (110.2 ± 10.4 cm), systolic (128.7 ± 7.8 mmHg) and diastolic (86.2 ± 6.8 mmHg) blood pressure were higher than recommended levels. Significant improvements (p < 0.05) were found for total body weight, BMI, waist and hip circumferences, cardiovascular fitness, lower limb strength endurance, systolic blood pressure, total energy, total fat, total unsaturated fat, monounsaturated fat, saturated fat, trans fat, total carbohydrate, sodium, cholesterol and percentage energy intakes of total fat, saturated fat, protein, and physical and mental health scores. Irish farmers remain at high risk of developing chronic diseases but respond positively to lifestyle intervention.

Community-based intervention for cervical cancer screening uptake in a semi-urban area of Pokhara Metropolitan, Nepal (COBIN-C): study protocol for a cluster-randomized controlled trial

BackgroundPrevious studies suggest that health intervention designed to increase cervical cancer screening has been effective to reduce cervical cancer incidence and mortality. The aim of this study is to determine the effect of a home-based health education intervention for increasing cervical cancer screening uptake delivered by trained female community health volunteers (FCHVs), a category of community health worker in Nepal.MethodsA community-based, open-label, two-armed, cluster-randomized trial [seven clusters (geographical wards) randomized for the intervention, and seven for the control arm]. The participants are recruited from a population-based survey with a sample size of 884. Based on population proportion size, 277 women will be recruited for the intervention group and 413 women recruited for the control group. A 12-month community-based health education intervention will be administered mobilizing the FCHVs, based on the Health Belief Model. The primary outcome measure of the study will be the difference in percentage of cervical cancer screening uptake between the two study arms. The primary outcomes will be modeled by using mixed-effect logistic regression analysis.DiscussionCOBIN-C is the first study investigating the effect of a community-based health education intervention by FCHVs on increasing cervical cancer screening uptake among women in Nepal. The purpose of this study is to develop and implement a home-based, culturally sensitive program to increase cervical cancer screening coverage at the community level.Trial registrationClinicalTrials.gov NCT03808064. Registered on January 14, 2019.

Knowledge, Attitude, and Practice of Adolescent Girls towards Reducing Malnutrition in Maiduguri Metropolitan Council, Borno State, Nigeria: Cross-Sectional Study.

Addressing the gap in knowledge, attitude, and practice among adolescent girls are important as malnutrition has a negative effect on their future generation. This study aimed to determine the knowledge, attitude, and practice of adolescent girls towards reducing malnutrition in Maiduguri Metropolitan Council, Borno State, Nigeria. This was a school-based cross-sectional study conducted among 612 adolescent girls (10 to 19 years old). KoBo collect toolbox was used for the data collection between 3 June and 31 July 2019. Multivariable logistic regression was used to identify predictors of knowledge, attitude, and practice towards reducing malnutrition. The majority of respondents (451, 80.2%; 322, 57.3%) had poor knowledge and attitude towards reducing malnutrition respectively, 278 (49.5%) had poor practice towards reducing malnutrition. Schooling (GGSS; p = 0.022; Shehu Garbai; p = 0.003) was a significant predictor of knowledge. Religion (p = 0.023), information (p < 0.001) and motivation (p < 0.001) were significant predictors of attitude. School (GGSS; p < 0.001; GGC; p < 0.001; Shehu garbai; p < 0.001; Bulabulin; p = 0.030; Zajeri day; p = 0.049), education of father (p = 0.001), information (p = 0.026) and behavioral skill (p = 0.019) were significant predictors of practice. There is a need to focus on both school-based and community-based health education intervention to address the poor knowledge, attitude, and practice among adolescent girls for a healthier future.

Evaluating an Oral Health Education Intervention in Chinese Undocumented Migrant Mothers of Infants in Northern Ireland.

Background: Poor oral health remains a significant dental public health challenge for ethnic minority and immigrant groups living in the UK. This study aimed to evaluate a culturally appropriate community-based home visiting oral health education intervention for Chinese, undocumented migrant mothers to promote their infants’ oral health, by focusing on their oral health related knowledge, attitudes, and behaviors. Methods: A convenience sample of 36 Chinese mothers with babies aged less than eight weeks were recruited in South-East region of Belfast. The local Chinese community was consulted to assist with the development of the intervention. The oral health education intervention was provided to 19 intervention group mothers through home visits and telephone calls during mothers’ first postpartum year. They were also provided with unlimited social support during the intervention period. Mothers’ oral health related knowledge, attitudes, and behaviors regarding baby toothbrushing and sugar snacking were measured at eight weeks, six months, and 12 months. Results: A higher proportion of Chinese intervention group mothers had improved knowledge about baby toothbrushing at 12 months compared with control group mothers (χ2 = 14.12: p = 0.004). Significantly, more intervention group mothers’ oral health related attitudes were enhanced regarding baby toothbrushing and sugar snacking compared with control group mothers. Conclusion: This community-based oral health education intervention has shown effects in mothers’ self-reported knowledge, attitudes, and behaviors in the intervention group when the community based and culturally appropriate home-visiting program improved the mothers’ oral health related knowledge, attitudes, and behaviors.

Community-Based Health Education Intervention Programe On Substance Abuse Among College Of Education Students In Nigeria

Community-Based Health Education Intervention Programe On Substance Abuse Among College Of Education Students In Nigeria

Effect of a community-based health education intervention on participation in household chores among husbands of pregnant women in a rural community in Northwestern Nigeria

Introduction: Reduction of workload on pregnant women has positive effect on pregnancy outcome. However, participation in household chores among husbands of pregnant women continues to be low. This study assessed the effect of a community-based health education intervention on men’s participation in household chores during their wives’ pregnancy in a rural community. Materials and Methods: Its is a quasi-experimental study involving men whose wives were currently pregnant. Preintervention, quantitative, and qualitative data were collected from the men and selected community leaders. Then a three-component intervention was conducted in the study community as follows; interactive workshop with the men, a film show with interactive discussion, and distribution of Islamic calendar for the current year carrying messages on men’s participation in pregnancy care. Six months later, postintervention data were collected using the same approach as the preintervention survey. Quantitative data were analyzed using IBM SPSS Statistics 20.0 and qualitative data were analyzed manually. Results: Mean age of men in the study group was 37.6 ± 10.5 years, and in the control group, it was 35.8 ± 10.8 years (P = 0.275). Men’s participation in household chores was low and showed no statistically significant change between pre- and postintervention data in study (P = 0.937) and control (P = 0.941) groups. Qualitative data showed most men perceived and treated household chores as women’s responsibility. Conclusion: Participation in household chores by husbands of pregnant women was low, and health education intervention did not significantly increase it. Further studies should evaluate the effectiveness of engaging community and religious leaders in eliminating the norms of gender roles.

Prevalence, knowledge attitude and practices associated with onchocerciasis in Enugu east and Nkanu west local government areas of Enugu state, Nigeria

Onchocerciasis is still endemic in Enugu East and Nkanu West Local Government Areas of Enugu State. In this survey, the Knowledge, Attitude and Practice (KAP) and prevalence of onchocerciasis were evaluated. For the KAP aspect of this survey, Interviewers administered questionnaire was used as instrument for collecting information from Respondents who participated in the skin snipping exercise. Skin snips were collected for the prevalence survey. A total of 149 persons participated in the prevalence survey out of which 88 participated in the KAP survey. Correct knowledge of causative agent, mode of transmission and treatment of the disease were 21.60%, 21.60%, 22.72% respectively, which is quite low; while vector control and intake of ivermectin were 77.27% and 37.50% respectively. The result of the microscopic analysis of skin snips showed zero prevalence for both communities. However, palpitation exercise conducted just before skin snipping revealed the presence of nodules on some of the participants. Therefore a community based health education intervention on vector control, cause, mode of transmission and treatment of the disease to improved KAP on onchocerciasis as well as confirmatory analysis of skin snips using Polymerase Chain Reaction (PCR) is recommended. Keywords : Onchocerciasis, Onchocerca volvulus , Mode of transmission, Disease treatment, Ivermectin, Knowledge Attitude and Practices (KAP), Skin snips

Effectiveness of community based health education intervention about safe motherhood among pregnant females in Sharkia Governorate, Egypt

Effectiveness of community based health education intervention about safe motherhood among pregnant females in Sharkia Governorate, Egypt

Abstract A26: Tackling cervical cancer disparities through African American beauty salons: A community-based health education intervention

Abstract While traditional settings such as physician offices and community health agencies have had measurable success in delivering behavioral health interventions, they are less successful in recruiting underserved African American participants. Inner-city African American women, faced with multiple risk factors contributing to persistent health disparities, require a source of reliable health information in a setting that is easily accessible and credible to them. Salon-based health education programs are becoming increasingly popular for reaching African American females because they engage trusted members of the community (salon owners and hair stylists) in a location that represents care and reflects the tradition of sharing information through oral communication. We partnered with neighborhood hair salons to promote messages about persistent cervical cancer disparities and low rates of human papillomavirus (HPV) vaccination in the African American community. Study goals were to: (1) recruit eight beauty salons in low-income Philadelphia neighborhoods to serve as health education sites; (2) train hair stylist to be able to discuss cervical cancer disparities and HPV infection with their customers, and (3) increase knowledge and awareness about HPV, as well as intentions to vaccinate, among customers at each salon. Study inclusion criteria for customers consisted of being a young woman ages 18 to 26 or the caregiver of a young female ages 9 to 17. Stylists were trained by members of the research team to be able to briefly discuss cervical cancer and HPV with their customers during regular salon hours. Additionally, professional health educators were trained more substantially on the health topics and were placed in the salons to supplement the work of the stylists and provide a more in-depth educational experience for the customers. Survey data related to knowledge and attitudes about HPV and HPV vaccination were collected from customers immediately before and after the health education, and approximately one month later. Salon stylists and owners were interviewed post-intervention to assess their experiences with participating in the intervention. Two hundred and forty women from 10 salons were enrolled in the study. Roughly 60% of participants were caregivers while 40% were young women. Knowledge about cervical cancer and HPV infection increased significantly in both groups from baseline to endpoint and remained high at the one-month follow-up assessment. At follow-up, 68% of participants said that they had had a discussion with a friend or family member about what they learned, and 57% planned to talk to their doctor or their daughter's doctor about HPV vaccination. Sixty-two percent of caregivers reported that it was important that their daughter be vaccinated against HPV in the future. There were no significant differences between the caregivers and the young women on outcome measures of knowledge, attitudes, or intentions to vaccinate. During the post-intervention interviews with the stylists, many indicated that they enjoyed having discussions about health in the salon and that salons should continue to serve as venues of education for women in the African American community. The majority of stylists indicated that neither they, nor their customers, were aware of the magnitude of cervical cancer disparities among African American women nor the availability of the HPV vaccine as a method of protection for young women. Results of the study indicate that such community-based interventions are both feasible and effective in reaching populations not traditionally included in health education interventions. Citation Format: Amy Leader, Pamela Weddington, Ralph DiClemente, Gina Wingood, Alicia Jackson, Ivan Juzang. Tackling cervical cancer disparities through African American beauty salons: A community-based health education intervention. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A26. doi:10.1158/1538-7755.DISP13-A26

Quality of life in China rural-to-urban female migrant factory workers: a before-and-after study

BackgroundRural-to-urban female migrant workers have a lower quality of life compared to the general population. Improving these conditions remains highly challenging. This paper reports the health-related quality of life (HRQoL) of the female migrant workers in an educational project.MethodsIn this before-and-after study, a community-based health education intervention was developed to improve female migrant workers’ HRQoL and job satisfaction. A factory was selected as the location to implement the trial, using a before-and-after design. The education intervention included distribution and free access to study materials, monthly lectures, and counseling. The primary endpoint was HRQoL, and gynecological disease and job satisfaction were secondary endpoints. We assessed HRQoL at baseline and at 6-month follow-up using the Health Survey Short Form (SF-36).ResultsCompared to the baseline assessment, the participants at the 6-month survey reported higher General Health scores (standardized-β coefficients (Betas) of β = 0.056; P <0.001), Vitality scores (β = 0.066; P <0.001), Mental Health scores (β = 0.062; P <0.001), mental component summary scores (β = 0.040; P <0.001), and job satisfaction (Odds Ratio [OR] 2.104, 95% confidence interval [CI] 1.837-2.408; P <0.01).ConclusionsA community-based educational intervention, targeted at female migrant workers, appears effective in improving HRQoL and job satisfaction.

Practice and Content of Sex Education among Adolescents in a Family Setting in Rural Southwest Nigeria

A descriptive cross-sectional study to assess adolescents' view of the practice and content of sex education within the family setting in a rural Nigerian community and explore whether there is any association between parental communication on sex and adolescents' sexual debut and habits. Simple random sampling was utilized, while a semi-structured questionnaire was used to collect data from 350 respondents. Data analysis was by the Statistical Package for Social Sciences (SPSS version 11). Majority of the respondents (48.8%) were late adolescents, 291 (85.1%) had had sex education, most (45.7%) of whom were exposed between ages 10 and 14 years. The main content of parental sex education was HIV/AIDS prevention (51.9%), avoidance of pregnancy (40.9%), abstinence (38.1%), and basic information about reproduction and biology (35.4%). Poor attitude to parental communication on sex was associated with a higher likelihood of pre-marital sex (p = 0.001). Curiosity was the most common major reason for sexual debut. This emphasizes the importance of early sex education within the family setting and its possible impact in delaying sexual initiation. Promotion of parent-child communication about sexual issues is vital in order to improve the reproductive health of the adolescents in this environment. Community-based health education intervention programs for parents are recommended.

Epidemiology of Childhood Injuries in Rural Puducherry, South India

To study the epidemiology of injuries among children (<14 years) in a rural population. The present Cross Sectional Study was undertaken in rural Pondicherry. The trained second year medical undergraduate students paid house visits to all houses in five feasibly selected villages. The students interviewed the mother of children aged < 14 years and obtained information on injuries in last 1 year and its sources of treatments. The authors could obtain information for 1,613 households (96.7%). The data was entered and analyzed using Epi_info 6.04d software package. Overall, prevalence of injuries among below 14 years was 23% in the last 1 year. The prevalence of injuries among infants, 1-4 years children and 5-14 years children was 32 (15.2%), 110 (24.5%) and 274 (23.7%) respectively. Prevalence of injury was significantly higher among male children (p = 0.001). All injuries were accidental and 68.2% injuries occurred in home environment followed by that in school. Source of treatment for majorities of injuries (58.4%) were government doctors. Notably, village level Anganwadi workers (AWW) or Auxiliary Nurse Midwife (ANM) were not consulted for the treatment. Falls were the leading cause of injury. Fall on ground from height, burns, bite by scorpion/insect/snake/dogs, and road traffic accidents were the four leading causes of injury among children. There is a need for community based health education intervention for mothers, caregivers, school teacher and capacity building of village level health workers such as ANM and AWW. Health education message should include preventive measures for the leading causes of childhood injuries.

Impact of health education on health-related quality of life among elderly persons: results from a community-based intervention study in rural Bangladesh

This study examines the change in health-related quality of life (HRQoL) among (> or =60 years) elderly persons as a result of health education intervention. A community-based intervention study was performed in eight randomly selected villages ( n = 4; n = 4) in rural Bangladesh. A total of 1135 elderly persons was selected for this study. The analyses include 839 participants ( n = 425; n = 414) who participated in both baseline and post-intervention surveys. Participants in the intervention area were further stratified into compliant (n = 315) and non-compliant (n = 110) groups based on the reported compliance to the intervention activities. The intervention includes, for example, physical activity, advice on healthy food intake and other aspects of management. To create an enabling environment, social awareness was provided by means of information about the contribution of and challenges faced by elderly persons at home and the community, including information about elderly persons' health and health care. The intervention activities were provided to the elderly persons, caregivers, household members and community people for 15 months. The HRQoL was assessed using a multi-dimensional generic instrument designed for elderly persons. Multivariate analyses revealed that in the non-compliant group the probabilities of increased scores were less likely in overall HRQoL (OR 0.52, 95% CI 0.32-0.82). Among the CONTROL group, increased scores were less likely in the physical (OR 73, 95% CI 0.54-0.99), social (OR 0.37, 95% CI 0.27-0.50), spiritual (OR 0.60, 95% CI 0.34-0.94), environment (OR 0.36, 95% CI 0.26-0.49) dimensions and overall HRQoL (OR 0.44, 95% CI 0.32-0.59) (adjusted for age, sex, literacy, marital status and economic status). This study concludes that provision of community-based health education intervention might be a potential public health initiative to enhance the HRQoL in old age.

The Effect of Community-Based Health Education Intervention on Management of Menstrual Hygiene among Rural Indian Adolescent Girls

To study the effect of a community-based health education intervention on awareness and behaviour change of rural adolescent girls regarding their management of menstrual hygiene. A participatory-action study was undertaken in Primary Health Centres in 23 villages in Anji, in the Wardha district of Maharashtra state. Study subjects were unmarried rural adolescent girls (12-19 years). We conducted a needs assessment for health messages with this target audience, using a triangulated research design of quantitative (survey) and qualitative (focus group discussions) methods. Program for Appropriate Technology for Health (PATH) guidelines were used to develop a pre-tested, handmade flip book containing needs-based key messages about the management of menstrual hygiene. The messages were delivered at monthly meetings of village-based groups of adolescent girls, called Kishori Panchayat. After 3 years, the effect of the messages was assessed using a combination of quantitative (survey) and qualitative (trend analysis) methods. After 3 years, significantly more adolescent girls (55%) were aware of menstruation before its initiation compared with baseline (35%). The practice of using ready-made pads increased significantly from 5% to 25% and reuse of cloth declined from 85% to 57%. The trend analysis showed that adolescent girls perceived a positive change in their behaviour and level of awareness. The present community health education intervention strategy could bring significant changes in the awareness and behaviour of rural adolescent girls regarding management of their menstrual hygiene.

The design of a community-based health education intervention for the control of Aedes aegypti.

This report describes the process used to develop locally appropriate educational materials and to implement the education component of a community-based Aedes aegypti control program in Merida, Yucatan, Mexico. The process is broken into five stages: formative research, developing recommendations for behavior change, development of educational messages, development and production of educational materials, and distribution of the materials. Appropriate terminology and taxonomies for dengue were obtained from open in-depth interviews; baseline data from a knowledge, beliefs, and practices questionnaire served to confirm this information. A larval survey of house lots was carried out to identify the Ae. aegypti larval production sites found on individual house lots. This enabled the program to target the most important larval habitats. Community groups were organized to work on the development of messages and production of the educational materials to be used. The education intervention was successful in stimulating changes in both knowledge and behavior, which were measured in the evaluations of the intervention. To be successful, community-based strategies must be flexible and adapted to the local setting because of ecologic, cultural, and social differences between localities.

Determinants of night blindness in Bangladesh.

A cross-sectional study was conducted to evaluate the effect of a community-based health education intervention programme and to study the determinants of night blindness in Bangladesh. The intervention programme was implemented to reduce the morbidity of nutritional blindness (night blindness) in the northern part of Bangladesh (Ranjpure district) during 1986-1989. A baseline study in 1986 covered 2010 households with a total population of 11,600, and the evaluation study in 1989 covered 2011 households with a total population of 10,456. Prevalence of night blindness was studied among children aged < 9 years in these households. The prevalence of night blindness per 1000 children was reduced significantly during the intervention period from 50.7 in 1986 to 26.7 in 1989. However, the post-intervention prevalence varied significantly between areas. Multivariate analyses showed that consumption of fish, meat, milk or eggs, dark green leaf vegetables, yellow fruits and vitamin A capsules were significant predictors of night blindness. In addition, family income, mother's literacy, family size and area of residence exhibited strong and statistically significant associations with night blindness in the 1989 cross-sectional study. The prevalence of night blindness was highest among 4-6 year old girls and 7-8 year old boys. The sex difference was, however, not statistically significant.

Trachoma

Trachoma causes one-quarter of the world's blindness and, although it has disappeared from many developed areas, it remains a major problem, especially in underprivileged rural areas in developing countries. Recent advances in the understanding of the molecular biology of chlamydia offer encouragement for the eventual development for an effective trachoma vaccine. Advances in the understanding of the epidemiology of trachoma, particularly of the importance of reinfection and the intrafamily transmission of infection, have led to the identification of the key importance of simple hygiene measures such as facial cleanliness in preventing the transmission of trachoma. Community-based health education intervention programs are being developed to assess the efficacy of a public health approach to the control of trachomatous blindness.