Designing and pilot-testing a health promotion programme targeting early school-age children for influenza prevention in Hong Kong

Abstract

BACKGROUND: Suboptimal hygiene practice predisposes young children to influenza infection during epidemics . Transmission in schools, besides causing occasional severe complications and mortality, also lead to interruption of children’s study . Previous studies suggested that hand hygiene interventions were effective for mitigation of influenza transmission in school settings . However, most existing traditional health promotion approaches and materials may have suboptimal effectiveness for improving hygiene practice in young children due to their difficulty and incomprehensibility to this age group. METHOD: To target this important gap in health promotion, we designed an outreach health promotion programme, including educational materials and interactive activities, tailor-made for early school-age children to cover key messages of influenza transmission and prevention, coughing and sneezing etiquette, proper hand hygiene training and proper facemask application . Planning phase began in Apr 2016 and pilot runs were performed in Jun 2016 in one kindergarten (K3, aged 5-6) and one primary school (P1-2, aged 6-8) . The main programme will be launched in 50 schools in coming academic year 16-17 . The programme is being evaluated under the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework . RESULTS: The programme and materials were designed to get across the key messages and skills in an attractive and understandable format to this group of audience . Special materials include cartoon figures and information on leaflet, story board, stickers, badges and a handwashing song adopting the familiar melody of the “Happy Birthday” song to satisfy the 20-second duration recommended by the CDC, with updated lyrics covering the 7 steps hand hygiene technique to facilitate familiarization and memorization . The 30-minute face-to-face interactive drama was delivered by our trained study team. Based on the RE-AIM framework, we developed evaluation plan including pre-tests and post-tests for children and teacher evaluation questionnaires . Pilot run of the programme gained satisfactory acceptance in teachers and students and suggested that our approach may be helpful for improving hygiene knowledge in young children and deserve more detailed investigation and evaluation in the main programme . CONCLUSION: Our preliminary evaluation results highlighted the importance of targeted health promotion design and approaches for making it acceptable and comprehensible in young children to achieve effective message delivery and skill transfer . Our main programme to be implemented in a larger scale in the coming academic year would help to give a better understanding on its potential impact and effectiveness on improving hygiene knowledge .