| BackgroundInfectious disease is one of the important public health problem in our country, emerging and reemerging infectious diseases is still a serious situationat present. Students are at high-risk of infectious diseases, the infectious disease emergency occurred frequently in high school. The epidemic or outbreak of infectious diseases, not only take an adverse effect on teenagers’ physical and mental health, but also impact on the normal teaching order, increasing the family burden, improper handling is likely to bring huge social impact.Improving theinfectious disease specific health literacy is one of the important measures to prevent the spreadand epidemic of infectious diseases. At present, nationwide intervention studies on infectious disease specific health literacy in middle school studentshas not yet been implemented, strategies, methods of intervention on infectious disease specific health literacy have not yet been proposed, intervention model and evaluation systemhave not yet been established. Therefore, based on national five-year science and technology support project "Popular technologyresearch and application of common infectious disease prevention" (2013BAI06B06), a study of effect on intervention of infectious disease specific health literacyamong senior one students in three provinces of China was implemented.Objectives1. To compare and validate the instant effect in different health communication way;2. By means of comprehensive application of different health communication intervention way, to explore the method and technology for improving thehealth literacy intervention level of infectious diseases among middle school students;3. To provide reference for high school students" health literacy intervention of infectious diseases.Methods1.Baseline survey:Using multi-stage stratified cluster random sampling method,2 urban schools and 2rural schools were selected in a province in eastern, central and western China, five senior one classes were investigated with randomly sampledin every school, all the students in these classes were investigated by self-administered questionnaire designed by "Popular technology research and application of common infectious disease prevention " (2013BAI06B06) to assess the health literacy rate of infectious diseases. And the intervention group and control group were assigned by cluster random sampling. In each province, one urban school and one rural school were selected as intervention groups, the others were control groups.2.Systematic intervention and comprehensive intervention:Combined field experiment with the community experiment, using the health belief model and innovation diffusion theory to design the content and method of infectious diseases health literacy intervention, a prospective intervention study was implemented in these schools.According to the statistics calculation, a total of 47 students were required inone interventiongroup, so 50 students in a class were selected as one intervention group.The first step was to implement 5 systematic interventions (field experiment) including reading foldingpropaganda, watching popular science video, health lectures, group learning and new media. Self-administered questionnaires were filled before and after the intervention, and scores were calculated to compare and validate the instant effect in different health communication way; eventually, there were 5 intervention groups in one school,30 in 3 provinces.The second step was to implement a period of 2-month comprehensive intervention using different health communication way. to explore the method, technology and channel for improving the health literacy intervention level of infectious diseases.3. Assessment tool Questionnaire survey "The Chinese public infectious disease specific health literacy scale (Crowns Bach coefficient is 0.84)"designed by "Popular technology research and application of common infectious disease prevention " (2013BAI06B06) was implemented in assessment; five aspects of individual infectious diseasespecific health literacy were assessed, such as the basic knowledge and concept of infectious diseases, infectious disease prevention, management and treatment of infectious diseases, the identification of pathogens and infection, and the cognition of infectious disease information and basic computing capacity, according to each topic difficulty coefficient to calculate scores, and the total score was 100 points.EpiData3.1 software is used to establish the database with double entry, and data consistency and data cleaning was performed. All the statistical analysis was performed by SPSS 20.0 software. t test and F test was used to compare statistical difference among different groups of health literacy, chi-square test was used to compare statistical difference of categorical variables. All statistical tests were two-side, alpha= 0.05 was considered as statistically significant.Results1. Comparison of health literacy scores of infectious diseases between intervention group and control group in baseline surveyIn baseline survey, the average scores of infectious disease specific health literacy was 62.08±16.65 in intervention group,62.84±15.48 in control group, the difference between intervention group and control group was not statistically significant (P>0.05), which suggested that it was comparable between the two groups.2. The influence of different intervention methods on infectious disease specific health literacy among senior one studentsThe average scores of infectious disease specific health literacy was 13.40 points higher than before in health lecture group, was 13.79 in new media group,10.93 in reading folding propaganda group,12.73 in learning group,7.58 in watching popular science video group.The study shows that theintervention effect was best in new media group and health lecture group, followed by learning group, was worst in reading folding propaganda group and watching popular science video group.3. The influence of different intervention methods on infectious disease specific health literacyamong senior one students of urban schoolAmong senior one students of urban school, the average scores of infectious disease specific health literacy was 16.69 points higher than before in health lecture group, was 14.20 in new media group,13.22 in reading folding propaganda group, 10.01 in learning group,8.3 in watching popular science video group.Among senior one students of urban school, the study shows that the intervention effect was best in new media group and health lecture group, followed by reading folding propaganda group, learning group, was worst in learning group and watching popular science video group.4. The influence of different intervention methods on infectious disease specific health literacy among senior one students of rural schoolAmong senior one students of rural school, the average scores ofinfectious disease specific health literacy was 10.27 points higher than before in health lecture group, was 13.39 in new media group,8.90 in reading folding propaganda group,15.45 in learning group,6.88 in watching popular science video group.Among senior one students of rural school, the study shows that the intervention effect was best in new media group and learning group, followed by reading health lecture group, was worst in folding propaganda group and watching popular science video group.5. Comparison of infectious disease specific health literacy scores between intervention group and control group in terminal assessment surveyIn terminal assessment survey, the average scores of infectious disease specific health literacy was 62.08± 16.65 in intervention group before intervention, was 74.04±17.55 after intervention, which was 11.96 points significantly higher than before (P<0.001)The average scores of infectious disease specific health literacywas 62.84±15.48 points in control group in baseline survey, was 63.41 ±15.76 in terminal assessment survey, which was 0.57 points higher than before(P>0.05), and it was not statistically significant.In terminal assessment survey, it was significantly higher than before in intervention group, the rate of top score was 14.1% before intervention, was 36.3% after intervention,22.2% significantly higher than before (P<0.001)6. Infectiousdisease specific health literacy scores among different characteristics participants in terminal assessment survey6.1 Gender difference:The average scores of infectious disease specific health literacy was 61.49±17.28 in male before intervention, was 62.62±16.04 in female, it was not statistically significant. After intervention, the average scores of infectious disease specific health literacy was 71.09±19.06 in male,76.17±16.10 in female, the female was significantly higher than male (P<0.05)6.2 Regional difference:In baseline survey, the average scores of infectious disease specific health literacywas 66.74±16.66 in Zhejiang province, was 63.89±15.45 in Hubei province, was 55.54±15.76 in Gansu province, it was statistically significant among three provinces. In terminal survey, the average scores of infectious disease specific health literacy was 72.33±16.00 in Zhejiang province, was 83.49±18.49 in Hubei province, was 66.42±13.54 in Gansu province, it was statistically significant among three provinces (P<0.05), and it was statistically significant before and after intervention in three provinces respectively.6.3 Urban and rural difference:In baseline survey, the average scores of infectious disease specific health literacywas 64.93±16.83 in urban school, was 59.20±15.96 in rural school, and it was statistically significant between the two. In terminal survey, the average scores of infectious disease specific health literacy was 80.19±18.58 in urban school, was 67.75±13.91 in rural school, and it was statistically significant between the two, and the scores in urban was more statistically significant than in rural.6.4 Health status difference:In baseline survey, the average scores of infectious disease specific health literacy was 61.50±16.70 in self-reported poor health students, was 62.36±16.62 in self-reported good health students, and it was not statistically significant between the two. In terminal survey, the average scores of infectious disease specific health literacywas 73.95±16.76 in self-reported poor health students, was 74.08±17.97 in self-reported good health students, and it was not statistically significant between the two groups, but it was statistically significant before and after intervention in the two groups.Conclusions1. The infectious disease specific health literacy will be improved in different intervention methods on among senior one students. The intervention effect was better in new media group, health lecture group and learning group than in reading folding propaganda group and watching popular science video group. In students of urban school, the intervention effect was best in new media group, health lecture group; In students of rural school, the intervention effect was best in learning group and new media group.2. Using the health belief model and innovation diffusion theory to design the content and method of infectious disease specific health literacy intervention, to comprehensively intervene in different methods, theinfectious disease specific health literacy was significantly improved among senior one students, and it was statistically significant in different region and in different characteristics students.3.In General, the infectious disease specific health literacywas poor among senior one students, and it was statistically significant indifferent region. The western was poorer than the middle and the eastern, the rural was poorer than urban, which suggested that special attention should be paid on the students in rural western China.SuggestionsThis study suggested that health education should be strengthened in high school students, and special attention should be paid on the students in rural students and students in western China. And health belief model and innovation diffusion theory for health communication mode and scientific operational mechanismshould be promoted, to make full use of new media, mass communication andinterpersonal communication to carry out for health education, to effectively improve health literacy level of infectious diseases, and to preventincidence and epidemic of infectious diseases in students. |
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